Nithe i dtosach suíonna - Commencement Matters

Air Ambulance Service Provision

I welcome the Minister of State, Deputy Kehoe, to the House.

I welcome the Minister of State to the House. There are men and women going about their normal daily business in the midlands today who would not be with us were it not for the fantastic service provided by the Irish Air Corps, the National Ambulance Service and the AC112 air ambulance helicopter, based in Athlone, since 2012. Similarly, men and women are going about their daily business today unaware of the fact that they may one day need these services. The service is called upon on a nearly daily basis. Last year alone, it responded to 159 serious car crashes and 146 other medical emergencies, and provided 15 urgent transports of children to hospitals. The Minister of State will understand that there is a degree of concern in my home town of Athlone and the surrounding counties regarding any threat to the future of this service.

I understand the current situation and ongoing HR challenges faced by the Air Corps, particularly with regard to the recruitment and retention of pilots. I also understand that for training reasons, the Air Corps will not be in a position to accept emergency aeromedical requests by the National Ambulance Service for four days per month between now and the end of February 2020. Furthermore, I accept that the Irish Coast Guard will provide reserve cover to the National Ambulance Service for the 16 days during which the Air Corps is not accepting taskings, and that further backup from the Cork-based Irish Community Rapid Response, ICRR, helicopter has been explored.

I am not happy that we are in this situation. I have been a constant thorn in the Minister of State's side regarding funding for the Defence Forces. I accept that this training is necessary and that the cover arrangements put in place aim to provide the best service possible using all available resources. However, there is fear in the midlands, particularly in Athlone, that this is the thin end of the wedge, which might signal the winding down of this very valuable service. This fear has been stoked by certain public representatives for their own political purposes, but is nonetheless causing concern among the general public. I would like the Minister of State to allay those concerns. I ask him to address only one issue, namely, the future of this service. I do not need to hear an explanation of the current situation or the provisions put in place to address it. I have heard and understand the assurances from the Department in that regard. I am asking the Minister of State to make an unequivocal statement in this House that the service provided by the air ambulance helicopter in Athlone will not be wound down or reduced in any way and will continue to be based in Custume Barracks in Athlone.

I thank Senator McFadden for raising this important matter. The emergency aeromedical support, EAS, service based in Custume Barracks in Athlone is an important service provided by the Air Corps. Notwithstanding the well-documented ongoing HR challenges in the Air Corps, particularly the recruitment and retention of pilots, the EAS service has been delivered without interruption since it was put in place by the Fine Gael-led Government in 2012. I have prioritised this service and will continue to do so into the future.

I have received military advice that the Air Corps will not be in a position to accept EAS taskings from the National Ambulance Service for four days per month for a period of four months, from November to February 2020.

That is regrettable but necessary for safety and governance reasons. During this time there will be a training surge to produce a new cohort of aircraft commanders for the emergency aeromedical service, EAS. This will ensure the long-term viability of the service provided by the Air Corps.

The safety of personnel, HSE staff and patients is paramount to me and our foremost shared priority. Our focus is on returning the EAS to full capacity from the end of February 2020. During the 16 days when the Air Corps will not accept taskings, the Irish Coast Guard will provide reserve cover for the National Ambulance Service. This is in line with the Government's decision in 2015 to establish the emergency aeromedical service. The Irish Community Rapid Response, ICRR, emergency medical service has agreed to provide additional cover using a second helicopter which will be based in Roscommon on the days when the Air Corps will not be in a position to accept taskings for the EAS. The ICRR will also continue to be available in the south of the country. I am focused on returning the EAS to a full service and full capacity. A number of measures are being pursued, including the reintroduction of the service commitment scheme for pilots, the recommissioning of former Air Corps pilots and the training of junior pilots during that time.

The emergency aeromedical service provided by the Air Corps has completed more than 2,600 missions since it commenced operations in 2012. I pay tribute to the professional and effective service provided by Air Corps personnel. I acknowledge the support of the Irish Coast Guard and the ICRR during this challenging period. The shared priority is to provide the best available service using all available resources during the four days in each month when the Air Corps will not be available for EAS taskings. This interruption is regrettable but necessary, as I stated, from a safety and governance perspective. The emergency aeromedical service operated by the Air Corps will continue. It is not being wound down. The service will continue to be provided by the Air Corps.

I pay tribute to the Air Corps for the professional and effective service provided by it. However, it is disappointing in this day and age that we have to rely on a helicopter provided by a charity. I thank the Minister of State for his assurance that the service will continue to be provided. However, he did not mention Athlone. In 2012 when Deputy Coveney was then in the position of Minister, I lobbied hard to have the air ambulance pilot scheme remain in place in Athlone. I have been happy with and proud of the service provided since, but there was no mention of it being maintained in Custume Barracks in Athlone. Will the Minister of State assure me that it will be maintained there?

I do not think there was any question that it would be relocated to any other location. The service will be maintained in Athlone. The ICRR helicopter is based in County Roscommon because it is a community service, while Custume Barracks is a military barracks. I hope the Senator understands the reasons we cannot have a community service helicopter operating out of a military barracks. If anyone has given her the idea that the service will be moved, I would appreciate it if she would go back to that person to say the service will continue to be based in Athlone, except for four days in November, December, January and February. It is not regrettable that we have a community service helicopter. It is happening all over Europe. It is a considerable feature in England where community and voluntary organisations provide helicopter ambulance services.

I do not see why we should not be able to do that in Ireland as well.

I very much welcome the help and assistance of the Irish Community Rapid Response helicopter. It is a fabulous service in the south of the country and covers a vast region. The service has two helicopters and the helicopter provided out of Roscommon is the second helicopter. The ICRR will continue to operate in the south of the country in addition to the service it provides in Roscommon. While I am not sure exactly from where in Roscommon the service is provided, it is to be very much welcomed that the ICRR came on board. When asked, it was available and willing to assist.

I can confirm to the House that, once the training is provided over the four days per month for the four months of November, December, January and February, it will be back permanently in Custume Barracks, Athlone from 1 March onwards. The service does a fabulous job there and has saved many lives, not just in the midlands or the west, but as far down as my own constituency in County Wexford, where a very important service is provided.

I remind the House there was a lot of pressure over a long number of years to have this service but it was a Fine Gael-led Government that introduced this scheme in 2012 and put it on a permanent footing in 2015, when a memorandum was brought to Government. I want to reaffirm that commitment. While we have our challenges, this service will return to full service from 1 March 2020, apart from four days per month in November, December, January and February, when the ICRR will provide a service for those four-day periods.

I thank the Minister of State for the clarification.

The Senator should be very happy with the Minister of State's response.

Hospital Staff Recruitment

I know this item will be of interest to the Leas-Chathaoirleach and to everybody in County Kerry. I thank the Minister of State, Deputy Finian McGrath, for taking the time to come to the House to give us an update on the issue of staffing levels in Kenmare Community Hospital. As the Minister of State will be aware, the hospital has been open since 2013 and, in fact, the official sod-turning by Senator Reilly, then Minister for Health, happened on 3 February 2012. Yet, despite the Government spending €8 million on this new facility, only 19 of the beds are open at this stage and 21 remain to be opened. We must bear in mind we have been waiting six years for the opening of the second floor of the hospital.

The excuse that has been given time and again in this House is the issue of recruitment. We are producing far more nurses per head of population than most European countries yet we are exporting most of them. They are being offered jobs in England, Australia and the Middle East, and they are taking up those jobs. For some reason, the offers that are being put out by the Government every year or six months are not being taken up, and that reason is that the pay and conditions are simply not good enough.

The excuse applies not only to Kenmare Community Hospital but also to Dingle Community Hospital, on which €14 million was spent and where 60 beds were provided but only 43 are open, again, due to the lack of nurses being recruited by the HSE.

I hope the Minister of State does not give me the same reply I got six months ago, a year ago, two years ago, two and a half years ago or any time I have been allowed to ask this question that it is still trying to recruit. It is six years on and if it is still trying to recruit for this hospital and all the other hospitals that have vacancies, the Government obviously has not identified the true problem, which is the Government, in that it is the one that is not giving the proper terms and conditions, and that is why people are not taking up the positions in this hospital and in all the other ones. I thank the Leas-Chathaoirleach.

I thank Senator Daly and I call Minister of State, Deputy Finian McGrath.

I thank Senator Daly for raising this very important issue, and of course I share his concerns about this particular issue. I am taking this matter on behalf of the Minister of State, Deputy Jim Daly. Residential care is provided through a mix of public, voluntary and private provision. It is worth highlighting that the net budget for long-term residential care in 2019 is €985 million, and more than 33,000 clients on average at any one time will be in receipt of financial support. Over the last two years, an additional €45 million has been provided to the nursing homes support scheme, NHSS, budget. In 2020, the NHSS will see a further investment into its budget of €45 million, bringing the total annual budget for the NHSS to €1.03 billion.

Public residential care units such as Kenmare Community Hospital, County Kerry, are an essential part of our healthcare infrastructure. In total they provide about 5,000 long-stay beds, amounting to 20% of the total stock of nursing home beds nationally. There are also about 2,000 short-stay community public beds.

The Health Service Executive is responsible for the delivery of health and personal social care services, including the Kenmare Community Hospital. HSE community healthcare organisation, CHO, 4, which includes County Kerry, is committed to delivering services for older persons through a community-based approach that is supporting older people to live in their own homes and communities and when needed in residential care, such as Kenmare Community Hospital.

Currently, there are 19 beds open at Kenmare Community Hospital with the potential to open up another further 21 in the future. While the HSE had planned to open a number of additional beds at the community hospital on a phased basis, it has unfortunately faced challenges in recruiting the extra nurses needed. The existing nursing staff complement for the 19 existing beds is 8.66 nursing whole-time equivalents along with 7.86 healthcare assistants. However, in order to open an additional nine beds, a further 5.11 nurses, whole-time equivalents, WTEs, are required, so another five nurses are required to open the nine beds.

I have been assured that the increasing capacity of Kenmare Community Hospital remains a priority for the HSE and that it is continuing to make intensive efforts to recruit nursing staff. I am also informed that the executive has run three recruitment campaigns in the last year alone, the most recent recruitment campaign being in September 2019, when every effort was made to recruit the necessary staff. Unfortunately, no suitable candidates were recruited at that time. The HSE fully understands the importance of Kenmare Community Hospital to the local community and appreciates the excellent care provided by the staff there.

I note that the recent inspection report published earlier this year by the Health Information and Quality Authority acknowledged that the centre was warm, bright and comfortable and met the needs of the residents, so we have great confidence in the hospital. In general, the inspector observed that the care and support given to residents was respectful, relaxed and unhurried. Staff were familiar with the residents' preferences and choices and facilitated these in a friendly and respectful manner.

The local HSE management has assured the Department of Health that it will continue to work to extend the services in Kenmare. The HSE has informed the Department that the hospital has an excellent reputation locally as a care facility and that the welfare of its residence is a priority for staff and management and that they are deeply appreciative of the support the hospital receives from the families in the wider community.

In line with the usual process, the HSE will continue to review all of its services to ensure the continued provision of high quality, value-for-money residential care with the older person at the centre of all decisions made.

I will bring the Senator's genuine concerns back to the Minister of State, Deputy Daly.

I thank the Minister of State for taking the time to come here to give the reply on behalf of the Minister of State, Deputy Daly. I will focus on the value-for-money element. There is no value for money in having a facility that cost €8 million with half of it empty for six years. While the Minister of State pointed out that no suitable candidates were recruited at the time, the real issue lies with the terms and conditions the HSE is offering staff. This is not just an issue for Kenmare or Kerry, but is nationwide. In talking about value for money, agency nurses are being brought in at a cost of hundreds of millions of euro per annum to fill the void in the hospital services. The terms and conditions for nursing staff is the problem for Kenmare community hospital.

People in Dingle are being sent outside the peninsula. A 90 year old woman cannot be cared for in her local community because the beds are not opened. The beds are not opened because the nurses are not hired. The nurses are not hired because the terms and conditions are not as they should be. Britain, Australia and other countries are benefiting from the nurses we are training but not willing to pay adequately. That will continue and I will be back here in six months, but hopefully not asking the same question and getting the same answer. I again thank the Minister of State for coming to the House.

I accept the valid points the Senator has made about Kenmare hospital. I acknowledge, as does the HSE, the importance of the role facilities like Kenmare community hospital provide to the people in the region. The welfare of residents is a priority for the staff and management who are very appreciative of the support the hospital receives from families and the local community. However, the HSE cannot open additional beds unless the appropriate level of nursing staff is in place to ensure the service provided is safe and of the optimum quality for elderly residents who require professional nursing care.

I take on board the Senator's point about highly trained nurses leaving the country along with his value-for-money economic argument on the €8 million it cost to build the hospital with the wards half-empty. He also spoke about the nurses' terms and conditions, and the high cost of agency nurses. I regularly say to Government that a lot of the resources could be spent in that direction. I will bring the Senator's concerns back to the Minister of State. The HSE will continue to make every effort to recruit the nursing staff for Kenmare community hospital.

Audiology Services Provision

While we await the arrival of the Minister, Deputy McHugh, I wish to welcome a group of foróige from my native parish of Kilmovee. I am told that counties Mayo, Roscommon and Sligo are represented. They are very welcome and I hope they enjoy their day in the Oireachtas.

I welcome the Minister to the Chamber. As he will be aware, I wish to raise the very important issue of educational supports for children who have been affected by failings in the audiology service in community healthcare organisation area 2 and, specifically, counties Roscommon and Mayo. I have been working with the parents of several children who have been affected by this issue for some time. The parents, who have been through a very difficult time, have done everything feasible in terms of their dedication and efforts to get the best for their children.

It is very important that we have a co-ordinated approach for these children. I am not satisfied with the way in which they and their parents have been treated. As the Minister will be aware, I am very dissatisfied at the level of cross-departmental co-operation in terms of securing supports. I was initially involved in the setting up of a cross-departmental approach but I am not satisfied with the results to date. During the summer, the parents worked extremely hard to secure chair silencers for classrooms. We were told there was no funding available and that it should come from a minor works grant. It is unbelievable that there is no funding within the Department to provide chair silencers for children who have been affected by an audiology misdiagnosis. After much back and forth between the Department of Education and Skills and the HSE, we finally got approval for chair silencers.

Some children have been approved for one sound field system, but many need two because they receive resource teaching in another room. Some have been approved for two. There is real inconsistency.

The HSE allowed for educational psychological assessments to take place and recommended iPads for some children but these requests have been refused by the Department. The result is that applications are made to the Department, refused and appealed, and the correspondence then goes to the HSE. The Minister will understand that by that stage one is many months down the road.

Obviously it is important that we support those children dealing with the challenges and difficulties of which I have spoken. It is critically important that we support them as they transition from primary to secondary school. I am not convinced, based on the evidence I have, that there will be long-term supports in place for these children. Their parents are not looking for extra supports. They have been let down by the State and have worked extremely hard since they received the letter of apology for having been let down. It is important that we support those children and their parents.

As a public representative in Roscommon I am very annoyed and dissatisfied with the way in which those children have been treated. I want to see a co-ordinated approach between the HSE and the Department of Education and Skills and for supports to be put in place as quickly as possible. I have reams of correspondence about what the Department and the HSE are doing but I do not have adequate evidence that enough support is being put in place. I know the Minister is aware of these issues but ask for an urgent approach to dealing with the additional supports that are required.

I thank the Senator for raising this important matter.

Following the HSE look back review of paediatric audiology services in Mayo, Galway and Roscommon, officials from my Department and the HSE met in September 2018 to discuss special educational supports for the affected children. It was agreed that where the affected children had special educational needs due to a hearing impairment, special educational needs supports could be provided in line with the various schemes operated by both my Department and the National Council for Special Education, NCSE.

My Department agreed to review the special educational supports provided to the affected children, to ensure that they are in receipt of supports in line with Department schemes and that supports provided are based on the children's individual needs. The HSE sought consent from parents and guardians to share affected children's details with my Department and the NCSE. To date, the details of nine children have been provided to my Department.

As a matter of priority, my Department in conjunction with the NCSE, completed its review of the special educational supports in place for each of the nine children and has now ensured that they are in receipt of appropriate special educational needs supports in line with the terms of various schemes. Supports available include: special education teaching support in schools; funding for assistive technology such as soundfield and FM systems; and guidance from the NCSE's visiting teacher service on classroom adaptation and school staff training.

All children are in receipt of special educational needs teaching support under the new model introduced in 2017 and revised in 2019. The new special education teaching allocation provides a single, unified allocation for special educational support teaching needs to each school, based on that school's educational profile, to allow schools to provide additional teaching support for all pupils who require such support in their schools. Schools deploy additional teaching resources based on each pupil's individual learning needs. The visiting teaching service has assessed the educational needs of all nine children and made recommendations to their schools. In accordance with the visiting teachers' service referral process and procedures, children with mild or unilateral hearing loss are placed on the "On Request" caseload and children with moderate-profound hearing loss are placed on the "Active" caseload of the visiting teacher. The visiting teachers have assessed the acoustic conditions in the schools and made recommendations to schools to put in place appropriate measures to cater for the children's needs.

All nine children have received assistive technology, in accordance with the criteria of the scheme. With regard to teacher training, the NCSE can provide direct support to the schools and individual teachers in as flexible a way as possible. Schools can apply for support through the NCSE's online application system, which is accessible via the NCSE website.

The NCSE offers telephone advice, school visits by a member of the team, in-service courses for individual teachers or whole-school training. Whole-school training will ensure all teachers are equipped to cater for children's educational needs as they progress through school.

Schools have been instructed to continue to engage with their local special educational needs organiser, SENO, and visiting teacher on the special educational needs of the children identified in the HSE review. Parents or guardians may also contact their local SENO directly to discuss their child's special educational needs using the contact details available on the NCSE's website. My Department has made direct contact with both schools and parents/guardians. A representative of my Department also met a group of affected parents/guardians in November 2018 and March 2019. The HSE and the Department of Employment Affairs and Social Protection, as well as the NCSE, were also represented at those meetings.

I thank the Minister for his response. There are, however, several issues that I want to clarify. The Minister has stated the supports include assistive technology. I am in contact with many parents of children who have been affected. The assistive technology being provided is not adequate to meet their needs. I gave the examples of the soundfield system and iPads. School staff training is not available in all schools. Parents are seeking access to the Jumpstarting literacy course which would help teachers to work with children affected, but that has not happened to date. There are several difficulties in the provision of support by the Department. although I acknowledge some supports have been put in place. However, we are not dealing with normal circumstances. We are talking about children who have been misdiagnosed. It is imperative that every possible additional support be put in place to allow the children who have had such a difficult start to make the greatest possible progress. There are several inaccuracies in what the Department has stated about assistive technology and school staff training. Will the Minister take these concerns on board? Will the Department respond urgently?

The Department of Education and Skills can only work on behalf of the children who obtain consent from the HSE. If there are additional support requests on behalf of the nine children, my Department will prioritise them. If there are other children identified by the HSE who require support or some assistive technology or funding, we can only work on the basis of consent. We will, however, continue to provide support for the nine children in question. If there are future applications, we will prioritise them. If the HSE identifies other children who need support and gives consent to the Department, we will also be in a position to support them.

Air Quality

I wish to raise the very important issue of air quality in our cities and towns. The Minister of State may remember that earlier this year, it was reported by the World Health Organization that levels of nitrogen dioxide, which comes from dirty diesel, were exceeded in Dublin and two other locations. Many of our rural towns are still burning dirty coal. By early next year, there is no doubt that we will be in breach of the EU safety levels for nitrogen dioxide. This is already having a serious health and environmental impact on the citizens of Dublin. I do not think it is a case of being found to have exceeded levels because I have spoken to the EPA, which told me that it is a matter of time as it has increased its monitoring within the capital. The EPA expects to have the results of this monitoring early next year and expects that we will be in violation of the limits. Where that has happened previously in other European countries, hundreds of millions of euro in fines have been levied.

We need to put a plan in place. We do not need to get official notification that the air quality in our cities is poor. We know that for a fact. It is within this Government's gift to start protecting our citizens. We should not necessarily be worried about the hundreds of millions of euro in fines this country could face but the fact that the EPA says that 1,180 people die prematurely because of poor air quality in our cities, mainly in Dublin, not to mention the number of families with young children that are affected leading to increased use of medication and illness. We must put a plan in place to improve our air quality. This decline in air quality has been caused by Government policy that encouraged people to drive cars running on dirty diesel. Those decisions were made in 2007 and 2008. We are losing over 1,000 citizens through premature death due to poor air quality.

Is the Government prepared to tell the four local authorities in Dublin to put a plan together to ensure that air quality does not breach EU standards? As I said, it has already breached World Health Organization standards. There is only one answer I need from the Minister of State - "Yes" or "No". If the answer is "No", the likelihood is that another 1,180 citizens will die in the next year. This number is far higher than the number of people who die through road traffic accidents. Must we say to affected families that their parent, brother or sister has to die because we have not been prepared to take preventative action now? We should not wait but do it now.

The EPA report entitled Air Quality in Ireland 2018, which was published in September, sets out the current status of Ireland's air quality. The report indicated that air quality levels at monitoring sites in Ireland were below the EU legislative limit values in 2018. However, it also showed that the stricter World Health Organization guideline values, which are lower and, therefore, offer greater protection, were exceeded at a number of monitoring sites for fine particulate matter, ozone, and nitrogen dioxide, N02. The report also indicated that EU limit values for N02 are likely to be exceeded in the near future at recently installed traffic monitoring sites in Dublin.

The main pollutants of concern are particulate matter from the burning of residential solid fuel and N02 from transport in urban area.

These findings were consistent with those that emerged from an earlier monitoring report from the EPA, Urban Environmental Indicators - Nitrogen Dioxide Levels in Dublin, which was released in July this year. It also indicated that some areas around certain heavily trafficked roads in the Dublin area may have higher levels of air pollution than previously indicated. These higher levels are due primarily to traffic and some locations are at risk of exceeding the statutory EU limit for the pollutant nitrogen dioxide or N02.

N02 is an air pollutant associated with urban areas and is strongly linked with traffic emissions. Diesel vehicles have historically far higher N02 emissions than other combustion engines, especially for older vehicles. Exposures to high levels over short periods can give rise to acute health effects, while long-term exposure to elevated concentrations of N02 may contribute to the development of asthma and potentially increase susceptibility to respiratory infections. People with asthma, as well as children and the elderly, are generally at greater risk from the poor health effects caused by N02.

Because of these health effects, N02 is a controlled pollutant under the clean air for Europe directive, which sets limits on N02 levels in the ambient air. An annual average limit value of 40 g per cubic metre is in place to protect against the human health effects of long-term exposure and an hourly limit value of 200 g per cubic metre protects against acute exposure.

While previous EPA reports had indicated that N02 levels were potentially problematic in Ireland and approaching EU limit values in urban areas, the July report in particular presented new evidence that N02 may exceed the annual EU limit value on certain city centre streets, along the M50 motorway and around the entrance and exit from the Dublin Port tunnel. It should be noted that the report also indicated that levels of N02 fall with distance from roadways and are well within EU limits away from busy roads and in many residential areas. Around the M50, the highest concentrations are within 10 m of the motorway edge, with levels falling to background levels at a distance of 50 m to 75 m.

The matter of air quality and particularly the potential human health effects of poor air equality are a matter of serious concern to this Government. This is why considerable support is being provided by my Department to roll out the national ambient air quality monitoring programme, under which additional air quality monitoring stations are being installed in Dublin and across the country. This programme is already providing better quality real-time information on localised air quality, which is very useful in the context of the development of air quality policies by my Department and in ensuring that local authorities take appropriate actions to tackle the challenge within their area of responsibility.

For example, preliminary results from one of these new stations, at St John's Road West, near Heuston Station, indicate that Dublin is on course to exceed the annual N02 limit value by the end of the year. If this happens, local authorities in Dublin and its suburbs will then be legally required to prepare air quality action plans to bring pollution levels back within the limit values in their area of responsibility.

The findings of the report are very concerning and only highlight the need to implement the climate action plan. This plan includes a number of actions which will have a significant impact on reducing emissions and improving air quality. These include the development of a regulatory framework for low-emission zones and providing local authorities with the power to restrict access to certain parts of a city or a town to zero-emission vehicles only. We are also committed to reaching 180,000 electric and hybrid vehicles on our roads by 2025 and nearly 1 million by 2030. Electrifying our private and public transport fleets will have a highly positive impact on air quality, particularly on N02 levels in our towns and cities.

In the meantime, the Government is, as a priority, establishing an inter-agency group whose membership will include the Departments of Public Expenditure and Reform and Transport, Tourism and Sport, four Dublin local authorities, the EPA, and other stakeholders as necessary to, inter alia, consider a range of options for potential measures to improve air quality and any associated actions and supports required to facilitate their effective uptake to address N02 and other air pollution and identify measures most suitable to Dublin, as well as in other urban locations in Ireland generally. A first meeting of this group is being arranged for the coming weeks.

This work will complement the work already under way by my Department's development of the whole-of-government clean air strategy, which will provide an overarching policy framework within which clean air policies can be formulated and given effect in a manner consistent with national, EU and international policy considerations and priorities. The clean air strategy will address priority air pollutants in Ireland, including vehicle emissions, in an integrated manner.

The Minister intends to launch the strategy at the earliest opportunity. I thank Senator Humphreys for highlighting the issue of air quality and I want to assure him of the Government's commitment to addressing the challenges facing Ireland in this context.

I thank the Minister of State for his analysis, which I note is the same analysis I received. The EPA told the Minister what it told me, namely, that Dublin is already exceeding the limits. Owing to the increase in monitoring we know that the limits are being exceeded. What was not mentioned in the Minister of State's analysis is that not three metres from the street on which the monitors are to be installed there are homes which are going to exceed the limits. The Minister of State is correct in saying that the local authorities in Dublin suburbs will then be legally required to prepare an air quality action plan. The experts have told this Government that we are going to exceed the limits. Why are we waiting? Why are the four local authorities not being instructed to prepare an air quality action plan to bring pollution levels within their areas of responsibility back within the limit values? That is the law. What we are seeing is an avoidance by Government of its responsibilities in that it is waiting for the EPA to install monitors, review them and then produce the proof that the limits are being exceeded, following which the four local authorities will be instructed to meet their legal requirement and bring forward a plan to reduce those limits.

I am calling on the Government to take its responsibilities seriously and to instruct the four local authorities to get working on the issue now because too many people are dying as a result of poor air quality. There are too many children in my constituency who are not able to go to school because they are suffering from asthma. Their medication is being increased on a regular basis in an effort to deal with this problem. It is not good enough to say that we have to wait until next year to prepare a plan. There is a legal responsibility on the four local authorities to produce a plan. I want the Government to instruct them to bring forward a plan to improve the dreadful air quality in this city.

The Government is treating this matter seriously. As I said earlier, the Government, as a priority, is establishing an interagency group, whose membership will include the Department of Transport, Tourism and Sport and the four local authorities and other agencies, to consider a range of options and potential measures. It is accepted that we have a problem. In raising the issue today Senator Humphreys has highlighted that it is an issue that needs to be tackled. I want to assure him that measures in the climate action plan will have a significant co-benefit to the work of this action group for air quality. An important investment in improvement of our national air quality monitoring capacity is under way, which is already yielding results that will help inform the most cost-effective and impactful policy measures that we need to take.

The results of the interagency group on urban transport-related air pollution and the forthcoming launch of the clean air strategy will build on this work and will help ensure that we achieve lasting reductions in the health environmental impacts of pollution in our city.