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Seanad Éireann debate -
Thursday, 1 Dec 2016

Vol. 248 No. 14

Commencement Matters

School Transport

Cuirim céad fáilte roimh an Aire. Ní bhfuair mé deis é seo a dhéanamh go poiblí ach déanaim comhghairdeas leis as ucht an pholasaí oideachais Gaeltachta agus as ucht an iarracht mhór a rinne sé ó thaobh na Gaeilge nuair a bhí an polasaí sin á sheoladh. I congratulate the Minister for Education and Skills, Deputy Richard Bruton, on the Gaeltacht education policy and the great effort he made to speak Irish on that occasion. It was very much appreciated and I thank him for it.

I am raising an immediate and a serious issue affecting a school in County Galway. I joined hundreds of children, parents and staff at Claddagh national school who were protesting against the cancellation of the bus service to the school last Friday. Further protests against cancelled city bus services could be on the cards if the Westside to Claddagh school service is not restored. Services from Westside to Claddagh, Scoil Einde to Seacreast and Claddagh to Westside via Salthill were all cancelled a number of weeks ago.

Claddagh national school principal, Mr. Michael Gallagher, has said that the aim of the march was to highlight the hardship of families and parents as a result of Bus Éireann's decision to cut the bus route that has existed for almost 30 years. Support for the restoration of the service is unanimous, both within the community and across the political spectrum. I joined with colleagues from across both Houses, including those in government who support this campaign, at the protest the other day. Locally elected representatives came out en masse to support the cause and it seems that everyone is in favour of restoring the bus route except Bus Éireann. The people are calling on us, as politicians, to intervene and to see what can be done to try to reverse this thoughtless and cruel decision. The school bus has been serving the school for almost 30 years and was cancelled without consultation or proper notification, just as winter began. Families with very young children are now walking several miles to school at the darkest, coldest and most dangerous time of the year. They feel it is deeply unfair. Members have been seeking a meeting with the Minister for Transport, Tourism and Sport, Deputy Ross, on this issue and a petition has been signed by more than 1,000 people.

I had a question put to the Minister but he said it was outside his area of responsibility, which I found quite strange.

I raise the issue today because this is going to have an impact on the children in the school. It is certainly having a very disruptive effect on the management and running of the school. I had a question put to the Minister to see if he or the Department of Education and Skills was consulted about the cut to this bus service, which is having an impact. As the Minister is aware, Galway schools are very full. There is little capacity and a lack of choice for parents who may want to try to move their children to a different school. That is not what is envisaged in this scenario. They would prefer the bus service to be there, but they would not have choice even if they wanted one. We have children and parents coming from an area where, in the main, they would not have their own transport. There is transport chaos in Galway anyway, so the more people we can have on the school buses the better to try to avoid that.

This is having an impact on the children who have to walk to school in the morning and walk home in the evening time. It also has an impact on parents, some of whom are working also. Was the Minister consulted and does he have concerns in this regard?

Níl an freagra as Gaeilge inniu, but I thank the Senator for his kind words. This issue really does not fall into our area. This service was not developed as a school transport service so there has been no communication with my Department about it. As Senators know, we transport some 113,000 children, including some 10,000 children with special educational needs, and the service has more than 4,000 vehicles. Children are eligible for transport where they reside not less than 3.2 km from the school they are attending. The school must be the school nearest to their home, as determined by the Department and Bus Éireann. A minimum number of ten eligible children residing in a district or locality as determined by Bus Éireann are required before consideration may be given to the establishment of school transport services, provided this can be done within reasonable cost limits. Bus Éireann operates the school transport scheme and has confirmed there are currently no school transport services operating to the school in question and no transport service has been withdrawn in recent years. I understand that the service to which the Senator refers is a scheduled service and is outside the remit of this Department. The information I have received is as the Senator has outlined that from the end of October, these Monday to Friday, term time only services were withdrawn. I understand that the company took the decision on a commercial basis. It would not be a decision in which my own Department would have had any involvement, be it the nature of the decision or how the decision was reached. All I can say with regard to the primary school transport system is that we apply it equitably across the State and treat every school on the same basis. This issue concerns a particular scheduled service for which we have no responsibility unfortunately.

I take on board what the Minister is saying, but the Government as a whole has a responsibility to ensure that children can come and go to school and that where a service is impacting on children who are going to that school, it is, therefore, an issue of concern to the Minister for Education and Skills if changes such as this are made without any planning with the Department. I implore the Minister to intervene with the Minister for Transport, Tourism and Sport, Deputy Ross, on this issue. Perhaps the Minister, Deputy Bruton, could contact Bus Éireann with regard to the service which has been changed or withdrawn to ask it if it could review the situation in light of the impact it is having on the students, parents and staff in the school in Claddagh.

Unfortunately, this is not a school transport service for which I have any role or relationship with Bus Éireann. Bus Éireann only runs the services we have agreed with it, based on national criteria. This is one that would not fall into my area. I understand that Bus Éireann has done a lot of restructuring of its services in Galway and has succeeded in building up the patronage by 50% through restructuring and better routes and services and so on. Bus Éireann is an independent body. It has public subvention but it must deploy the subvention as best it can within Galway. Unfortunately, it is for the Senator to speak to Bus Éireann locally to see what the context is for its decision and if there are alternative services on offer that would service these schools. I must stick to the national scheme which we apply equitably to every school that applies to the Department for a service on the basis of the criteria I have outlined. I have nothing in my tool box that would resolve this one I am afraid.

The Minister might help to support the campaign.

Local Authority Members

I thank the Cathaoirleach for selecting this Fianna Fáil Commencement Matter. We had asked for the Minister for Housing, Planning, Community and Local Government, Deputy Coveney, to come to the House, but I thank the Minister for State, Deputy English, for coming in. We had asked that the Minister would outline what he is doing, or what he is going to do, to improve the terms and conditions for our local authority members. The number of local authority areas has gone from 114 to 31. There are now 678 fewer local authority members, with the loss of town councillors and the reduction in some counties of county councillors. We now only have 949 local authority members, which is one of the worst voter to local authority member ratios anywhere in Europe.

I wish to share time with my colleagues who have come in to support this matter.

I welcome the Minister of State, Deputy English, to the House. As Senator Daly has outlined, this issue has been floating around for a while, and some would say for too long. I appeal to the Minister of State, and the Minister to grasp the nettle. We have all recognised that the workload and travel has increased significantly for councillors. Effectively it has become a full-time job. Unless we look after these hard-working councillors, who we are very fortunate to have, we will find it very difficult to get anybody to enter local government. It is time the issue was dealt with. It is the least they deserve. I acknowledge the support from councillors and from Senators in this House on this matter. I also acknowledge the work done by the Association of Irish Local Government and the Local Authority Members Association in trying to push this forward. I ask the Minister of State that this issue be addressed once and for all.

Cuirim fáilte roimh an Aire Stáit. This insult to councillors, which is the only way I can describe it, has gone on long enough. There is never a wrong time to do the right thing. I feel strongly about this. I call on the Minister of State to see that the Government stops playing with councillors. We are getting drip feeds in the newspapers every couple of months about expenses and we hear the words, "If I was in power" and "What I would do if I was in charge" said but the time for those games is gone. Half of the councillors rely on this as their sole wage. It is below the minimum wage.

I implore the Minister of State to draw a line in the sand on this and improve their pay and conditions. I am delighted to be able to support my fellow Senators. We have been working hard on this with the AILG and LAMA, no more than the Leas-Chathaoirleach, and we would really appreciate the Minister of State grabbing this nettle. We want to see some dividends.

I thank the Senators for raising this issue as it is an extremely important area of work and I am glad we have a chance to discuss it today. It certainly reflects the views of the councillors the Minister, Deputy Coveney, and I have met at various meetings in recent months with regard to Rebuilding Ireland and on other occasions. Very strong views were expressed. The Minister, Deputy Coveney, had hoped to be here and apologises he could not make it. He is chairing at a meeting on Ireland 2040 and could not leave it in time to get here. He wants to be part of this discussion and recognises the importance of dealing with the matter and has made commitments to do so. It is something which he holds very close to his heart.

Effective local government structures are an essential part of our democracy. In turn, effective local government cannot be achieved without the hard work and commitment of elected members who give of their own time in service to their community. As has been said this morning, for many it has become a full-time job because it is so busy. Many people dedicated their lives to it. A range of financial supports is already in place to assist councillors in their vital work. These include a representational payment, fixed annual expenses allowances, travel and subsistence allowances, a mobile phone allowance, a retirement gratuity and conference and training provisions.

The reforms introduced by the previous Government in 2014 addressed widely acknowledged weaknesses in the previous system, including the problems of divided administration between town and county authorities for key functions. Under the new municipal district system there is full integration of local authority resources across each county and elimination of duplication both in administrative and electoral terms.

As part of an operational review of the local government reforms, the Department conducted a survey last year of elected members, with the support of the Association of Irish Local Government. More than 500 elected members participated in the survey. The results indicate the revised structures are generally operating well but will need more time to bed down fully. Particular concerns were expressed, however, about increased work demands and the increased size of electoral areas. Apart from the submissions, we have also heard this in conversations with Senators and councillors throughout the country and it is a given at this stage. In this regard, A Programme for a Partnership Government includes a commitment to review the supports provided to councillors, in consultation with representative bodies, to enable councillors to continue their important and valued work.

Shortly after assuming office, the Minister, Deputy Coveney, met representatives of the Association of Irish Local Government and the Local Authority Members Association. The Minister has since attended the autumn seminars of both associations and is aware there is a strong view among the membership that positive consideration be given to their proposals for improvement in the range of supports available. The Minister intends to give further consideration to the issue, in consultation with the Minister for Public Expenditure and Reform, and to reach a conclusion as soon as possible in the context of wider public service pay policy and taking all relevant factors into account.

I wish to take the opportunity to refer to proposed amendments in the area of social welfare benefits. Section 10 of the Social Welfare Bill, which is before Seanad Éireann, provides that elected members will, in future, be brought into social insurance cover as self-employed people, in so far as entitlement to the wider range of benefits is concerned. This is an improvement on the current situation whereby elected members pay 4% PRSI but no benefits accrue from these contributions. I again thank the Senators for raising the matter. The Minister intends to, and will, give careful consideration to the issues raised by the representative associations and individual councillors and reach a conclusion in this regard in the very near future.

All we had outlined was what the Minister, Deputy Varadkar, has done. What we did not get is what the Minister, Deputy Coveney, will do, other than that he will look at the matter. We had a similar response yesterday on votes for the Irish overseas. The Minister is looking at a lot of things but he does not seem to be getting around to making a decision on anything. AILG and LAMA have made these proposals. The Minister, Deputy Varadkar, has acted under the Social Welfare Bill, as is his prerogative and right, but the Minister, Deputy Coveney, has failed to act and apparently has not spoken to and has not sought anything from the Minister for Public Expenditure and Reform, which is the process in the Government.

What we are hearing again is the Minister might do something soon, but he has not actually come to any conclusion and has not even spoken to the Minister of Public Expenditure and Reform to ask for anything on behalf of local authority members. We will lose local authority members throughout the country as they will not seek re-election because the workload has increased. In some cases, their areas are now as big as what used to be three seat Dáil constituencies. Their responsibilities have also increased because there are no longer town councillors to share the workload in some areas.

What we clearly see here is the Minister, Deputy Varadkar, has done something, which is welcome, on the PRSI issue, but we will be back here next year asking the Minister, Deputy Coveney, whether he has met the Minister for Public Expenditure and Reform and the councillors' groups, AILG and LAMA, and whether he has decided to do anything other than continue to look at the issue. I heard he might do something in June 2017. This simply is not good enough. It is not acceptable.

The Senator has made his point.

The Senator seems to be hearing a lot of things but I ask him to listen to what I am saying. There is a very clear commitment from the Minister, Deputy Coveney, to deal with this. He said this very clearly and I am repeating it here today. He recognises the difficulty and wants to put the issue to bed, which we will do in the very near future. He is committed to dealing with the issue. To say he has not had discussions or meetings is factually incorrect. I have attended meetings with him and had discussions with him. I assure the Senator, factually from the horses mouth, that he is working on it.

I know but he is unable to make a decision.

I would rather if the Senator did not make up-----

All we hear is "soon".

I want to be clear with the Senator. I would rather he did not make up stuff. I am telling him the Minister is working on it. I have been there with him at the meetings. He is working on it and it will be resolved very soon.

Is there a timeline on "soon"?

Hospital Services

I welcome the Minister of State, Deputy Catherine Byrne, the House.

I thank the Minister of State for coming to the House to deal with this matter. There is a major problem in Cork at present as the medical consultants and nursing staff on the front line have a difficulty providing gynaecological services. I understand there is quite a long waiting list of more than 4,000 people for either appointments or surgery. When all the maternity services in Cork were transferred, and three hospitals providing maternity services, the Bon Secours Hospital, the Eirnville Hospital and St. Finbarr's Hospital, were closed and amalgamated to CUH, two operating theatres were to be provided which would work at least five days a week. What has occurred is only one has opened and this works three and a half days a week. As a result, for a day and a half there is no access to the theatre. What is required for the theatre to be open for the extra day and a half is three more nurses. This would help to alleviate the list. What would also help to alleviate it is if the second theatre was opened. At present, some of the beds are being used with a turnover of three patients per day per bed for day cases. It is working fully to try to accommodate everyone. There is also a proposal for a day care unit with six beds, and the costings have been done on this. It would help to alleviate the problem.

When cancer services from the South Infirmary-Victoria University Hospital were transferred to CUH it was agreed a gynaecological unit would open there and a building was identified which would have had four beds for day care procedures. This has not been done. We now have a huge number of items not provided for although a commitment was given, and as a result the biggest maternity gynaecological unit outside of Dublin is running at half capacity. I ask that something be done about this.

I welcome the Minister of State but it is disappointing the Minister, Deputy Harris, is not here.

While the Minister of State has a big brief, I do not believe gynaecology is part of it. Women in Cork city are waiting longer for gynaecology services than women in any other part of Ireland. It is utterly unacceptable.

There are 4,193 women waiting for an outpatient appointment in Cork, the longest waiting list of all gynaecology units and twice the next longest waiting list. There are 557 women waiting for gynaecology surgeries, again the longest such waiting list. As Senator Colm Burke outlined, the gynaecology theatres are functioning at 40% of their capacity. Although we have two fully commissioned, state-of-the-art gynaecology theatres, they are not operating to full capacity. As Senator Colm Burke said, a small investment could have them fully operational. No new consultant gynaecologist posts have been created in Cork in the past decade, despite the fact that 26 posts were filled nationwide. The waiting lists are having devastating consequences for women. Women are in pain, bleeding and turning up at accident and emergency units in crisis. As a woman, the Minister of State knows a delayed diagnosis means cancer that could be treated might be growing. It is a life and death matter for women in Cork.

The solutions are clear. The Government must increase the gynaecology theatre to a five-day service, open the second theatre, develop the proposed gynaecology unit with Cork University Maternity Hospital, CUMH, bring forward the one-stop shop which was in the 2014 service plan and increase the number of gynaecologists. At the end of September, I raised the matter at the health committee, and the Minister for Health, Deputy Harris, asked me to write to him, which I did. He still has not had the courtesy to respond to me. It is very similar to what is happening locally. People have raised these matters and Senator Colm Burke is correct that relationships are very poor locally. We need the Minister to intervene to get the situation rectified for the women of Cork.

These unacceptable waiting lists will not go away on their own. If ignored, they will get worse, creating hardship and ill-health and putting the lives of women in Cork and surrounding areas at risk. Consultants in the hospital have been forced to say they cannot take responsibility for the adverse health outcomes arising from a well-documented chronic lack of investment which has resulted in the longest waiting lists in the country. Therefore, I ask the Minister of State to take back a message to the Minister for Health, Deputy Harris, namely, will he take responsibility, take action and resolve the issue?

I am not the Minister for Health, Deputy Harris. I have been asked to take the Commencement matter on his behalf. However, I am a woman and given that I have five children and have been obliged many times to go to accident and emergency units for gynaecology, I understand. I know how important it is to have a service up and running.

On behalf of the Minister, I thank Senators Colm Burke and Kelleher for raising the issue. I fully recognise the need to ensure patients have timely access to health services. The Department works closely with the HSE and the National Treatment Purchase Fund, NTPF, to implement measures to reduce waiting times. At the Minister's request, the HSE developed an action plan to reduce, by year end, the number of patients waiting 18 months or more for an inpatient or day case procedure.

It is important that the number of patients who are waiting to be seen or treated is considered in the context of the total numbers of patients actually seen and treated. Every year, there are more than 3.2 million outpatient attendances at our hospitals, 94,000 patients have an elective inpatient procedure and 1 million patients have a planned day case procedure. The budget for 2017 provides evidence of the Government’s commitment to a sustained focus on improving waiting times, particularly for those waiting longest. The Government has allocated €20 million to the NTPF for the treatment of our longest-waiting patients. This will be increased to €55 million in 2018.

I am aware there is a difficulty with waiting times for gynaecology services in Cork University Hospital. The south-south west hospital group has confirmed its commitment to obstetrics and gynaecology services as demonstrated by the establishment of a group clinical directorate for these services. The HSE has also advised that Cork University Hospital is undertaking a number of initiatives to address both inpatient and outpatient waiting times for gynaecology services. This includes additional evening outpatient review clinics, which are led by a member of the consultant gynaecology team. The hospital has recently appointed a gynaecology sonographer, who will lead an ultrasound service in liaison with the consultant gynaecology team. With the additional scheduled consultant-led evening sessions, the hospital management anticipates that the gynaecology ultrasound waiting list will be cleared by December 2016. My Department has been assured that to address the current difficulties, the hospital will maximise the use of existing theatre and other gynaecology resources within the hospital, as well as those in other hospitals across the south-south west hospital group.

In line with the national maternity strategy, a national women and infants health programme is being established within the HSE to lead the management, organisation and delivery of maternity, gynaecological and neonatal services. The programme will drive implementation of the national maternity strategy and ensure the consistent delivery of high-quality care. Noting that the international trend in gynaecology service provision is moving towards more day-case services and the provision of community one-stop shop type facilities, it is intended that the programme will drive much-needed reform of gynaecology services. This will include the potential to adopt a multidisciplinary approach and move some service delivery to community settings. Work to establish the programme is ongoing.

I am disappointed in the reply. It is like what I get at the health committee. At the last meeting of the health committee, I raised four questions to which I got answers to only two. There seems to be a problem with the HSE in the south giving the truth. The truth is not contained in this answer. The answer to the problem is to open the operating theatre five days a week, not three and half days a week, and to move towards providing additional day-case beds for patients so the hospital can turn over far bigger numbers. The response is extremely disappointing. It does not deal with the issue. What the Minister of State set out will not do one thing for the waiting list.

If something is not done immediately, within six months the waiting list will increase from 4,000 to 5,000 or 6,000. The list increases every day. There seems to be a stand off between people in different sections of the hospital, between people at the front line and those in management. The people in management do not appear to be taking the matter seriously. The Minister of State's response is inadequate and a clear message should be sent to the manager in Cork University Hospital that it is unacceptable. I will raise this again and again, next week and the week after, as long as we are sitting up to Christmas. It is not going to go away.

I concur with Senator Colm Burke. This matter is not being taken seriously. I wrote in September and have not had the courtesy of a response. The local consultants have been tearing their hair out trying to get a response. Yet, women are waiting, getting more ill and are bleeding and suffering. The fact that the Minister for Health is not here shows that it is not a priority for him or for the Government. Senator Colm Burke is right. It is not going to go away. There will be a "Prime Time Investigates" programme on the issue. Will we wait for that before we take action? We have the facts. While I thank the Minister of State for coming, there is nothing in her response that gives me any comfort to expect that any action will be taken or that the issue has registered as any kind of priority for the Minister for Health or the Government.

I understand the Senators' frustration and concur with some of the things they have said. My response did not specifically identify some of the issues they raised. However, things are happening in Cork University Hospital. Let us not be in any doubt that the Government is committed to providing a better service for women, particularly in gynaecology. The money that is being set aside and allocated to the NTPF will alleviate long waiting lists. Moreover, the new service will continue in some evenings in the hospital.

According to this statement form the Minister's office, the gynaecology ultrasound department hopes to clear its waiting list by December. I have taken note of all the issues both Senators have raised and I will bring them back to the Minister. As a woman, I believe that delayed diagnosis in any gynaecological area can be fatal. I will stress that to the Minister. I will also ask why the Senator has not received a reply to her letter. Out of courtesy, that should be done straightaway. I will raise the issue of the theatre only being used for 3.5 days a week. Apart from that, I cannot give any other message on what is happening in Cork until I go back to the Minister and relay the Senators' deep concerns.

A Leas-Chathaoirligh-----

There are no further supplementary questions now.

I really think we should open the theatre for five days.

There is no facility for further supplementary questions.

Medicinal Products Availability

I thank the Minister of State for coming to the House. I do a lot of work with nutritionists and dieticians. Recently some people contacted me about low-protein foods, a very specific issue that affects a relatively small sector of the population. Nonetheless it is very important to those individuals. The lack of availability of low-protein foods is very serious for those with metabolic illnesses.

Approximately one in every 45,000 babies born in Ireland is diagnosed with phenylketonuria, PKU, and approximately one in every 65,000 babies born in Ireland is born with homocystinuria HCU. Both are very rare genetic disorders causing the body to be incapable of breaking down amino acids, which are present in protein foods. This is a metabolic disorder and patients must manage their lifelong illnesses with a low-protein diet to prevent neurological damage.

Obtaining low-protein food products is proving to be increasingly difficult in Ireland. I recently received information from an individual two of whose children are suffering from HCU. Prescribed low-protein foods are crucial to managing their diets. This individual is becoming increasingly frustrated as not only are low-protein foods not readily available in local shops, but there is also a lack of high-quality low-protein food products in the Irish market in general or on the long-term illness card.

Given that prescribed low-protein foods are required to prevent neurological damage and to supplement the diets of adults and children with PKU and HCU, why have no low-protein products been added to the long-term illness card list in more than six years? I ask the Minister for Health to ensure a full and appropriate list of foods prescribed for PKU and HCU is added to the reimbursement list.

I am glad to be here this morning to take this Commencement Matter on behalf of the Minister, Deputy Harris. I thank the Senator for raising this issue. PKU and HCU are lifelong conditions, with serious dietary restrictions for people who have them. Essential clinical nutritional products, specifically for PKU and HCU, as well as some low-protein foodstuffs, are reimbursed under the community drugs schemes. I am aware that there has been little or no variation in this list for several years.

The HSE primary care reimbursement service, PCRS, has just published revised guidelines for manufacturers and distributors on the reimbursement of clinical nutritional products. These guidelines were last updated four years ago. The expert group which revised the guidelines was drawn from hospital and community settings, and included procurement support. Manufacturers and distributors were consulted on the draft guidelines, as was the Food Safety Authority.

For a product to be reimbursed, the supplier must apply to the HSE for approval, and products must meet published criteria. For pricing, the HSE is prepared to consider several factors. However, there are a number of broadly similar products, and it intends to have a single price mechanism for such products, so that similar patient benefit receives similar reward. When the HSE receives applications for clinical nutritional products under the new guidelines, it must consider the approval criteria set out in the 2013 Health (Pricing and Supply of Medical Goods) Act.

Regarding reimbursement criteria, the Senator may be aware that, as PKU is on the long-term illness scheme, the HSE has, in the past, made exceptional arrangements for essentials such as bread and other like products. It is prepared do so again, on an individual basis, taking into account the price constraints I have outlined. For example, where a product is dietician-recommended and is less than an existing reimbursable item, it may continue to be approved on a patient-specific basis.

I would like to see expansion of the range of items available for people with PKU and HCU. Over a decade ago, the situation was similar for gluten-free foods, especially for dietary staples like bread. Now, quality, choice and availability have vastly improved and people who need these items can get them in a wide range of outlets.

However, the State does not commission for reimbursement - suppliers must make their products available. New products have come to market elsewhere in recent years and suppliers have not sought reimbursement yet in Ireland. Specialised products for PKU and HCU are unlikely to appear outside pharmacies, but in particular low-protein food staples should follow the path of gluten-free products. These are not technical products or specific to PKU and HCU, and should be available to anyone who wants them. I would like to see their range and availability increase, as happened for gluten-free foods, so that people on these extremely restrictive diets can have a much better choice and variety of food, as everyone else does.

That is the reply from the Minister. I have taken some notes and I will take more after the Senator responds.

I am pleased that the Minister acknowledges the deficit in this area. I am not sure that his indicating he would like to see the range and availability of these items increase is sufficient for me. Perhaps I might have a conversation with him at some point about this. I am pleased he has acknowledged the need to address the issue but there does not seem to be any particular strategy. I welcome that new guidelines have been published. To make it a reality might take more effort.

I am sorry that the answer has not fully cleared up the issues the Senator raised. I will meet the Minister, Deputy Harris, today and I will raise her concerns with him. I have personal experience of somebody at home who had a child who needed special food and because of the cost it was difficult for them to get it.

Sitting suspended at 11.20 a.m. and resumed at 11.35 a.m.