I thank the Minister, Deputy Roderic O'Gorman, for coming into the House in relation to the issue of the mother and baby homes. Many Senators would have met Ms Sheila O'Byrne, who has been outside the gates of Leinster House on many occasions on this issue. She was in St. Patrick's on the Navan Road. She is a passionate advocate for the rights of people, such as herself, who were in those institutions and a voice that, like many others, must be heard.
Nithe i dtosach suíonna - Commencement Matters
Mother and Baby Homes Inquiries
I thank the Cathaoirleach. I thank the Minister for coming into the House. This is an important issue to my constituents, his constituents and survivors all over the world.
When the Minister came into the House in October of this year, he brought forward legislation to prevent the destruction of the records and the database from the commission of investigation. My colleague and I supported that legislation because we thought it was critically important that the database and records that had been assembled by the commission of investigation in the course of five years' work, detailing the history over 75 years, 18 institutions and more than 70,000 individuals, mothers and babies, would be protected and an unredacted form would be kept.
I asked the Minister at the time to take action, and I appreciate that he did, to ensure that the database and the records would be protected and that a complete version of it would be kept in the Department. I also sought guarantees around access to the personal data for the survivors and their children, that there would be an anonymised index published and that the Minister would champion the establishment of an archive in Sean McDermott Street.
I asked for the Minister to come to the House today in order that he could update the House on how survivors and their children will get access to their personal records. How will witnesses who gave testimony to the commission get access to their transcripts? How will information on the unmarked graves of those babies be made available?
Finally, the Minister might update us, if he can, on the Government's position on establishing an archive on Sean McDermott Street. It would be informative. Most importantly, what I am looking for an update on the Government's work to protect the records and the databases and, most critically, to give the survivors and their families access to their personal information to reclaim their identities, to know who they are, to end this terrible pain and shame and to bring this really dark period in our history into the daylight.
I thank the Minister for coming into the House. As Senator Fitzpatrick said, this is a really important issue. We all have cried a tear and listened to many of the survivors in this country and the adoptees of those survivors who lived in the mother and baby homes.
There are a few things I will mention that continue on from what Senator Fitzpatrick was saying. Tusla has stated in the media over the past couple of days that it fears it does not have sufficient staff to deal with the complex work that has emerged from even an initial assessment of the database. We now have a protected database. We have a report coming out that will raise hurt, fear and anxiety among survivors and I hope that we can, for the want of a better word, take an holistic approach to this. We need to look after these women and adoptees. We must prioritise them for mental health supports. Women who do not want to be found must have their privacy protected. I have spoken to women who fear that their past is going to be brought back in front of them and they do not want that because they have left the past behind. There is a balancing of rights issue there, as we have previously spoken about in committee.
I also want to make sure that we have no ambiguity as to the process, what is going to happen to this database and how these survivors and adoptees are going to find out about their past. The timelines and formalities around requesting information must be clear. We must make sure that these women and adoptees are looked after because it is going to be hard on all parties and they need minding, looking after, care and consideration.
I thank both Senators for giving me the opportunity to provide an update on some of these matters. As they know, I received the report of the Commission of Investigation into Mother and Baby Homes on 30 October. As Senator Fitzpatrick mentioned, the report has been years in the making and survivors want to see it published soon. I share that wish. It is important that this report be published so that all of us can collectively understand better the experiences of the women who were in mother and baby homes and the experiences of the children who were born there.
Once the Government has given approval for publication of the report, I will engage directly with former residents as key stakeholders who are central to these issues and provide them with the details of the report and the proposed next steps. I am acutely conscious of the anticipation experienced by former residents and their families awaiting the publication of this report and I assure Senators that there will be no undue delay in bringing the report forward for publication.
I have already been in direct contact with a considerable number of former residents by telephone and, in line with commitments already in place in this regard, my Department will make contact directly with former residents through existing communication channels to inform them of these matters before they are brought into the public domain. There is already a dedicated telephone information line available within my Department. Those details are available on the Department's website for people seeking further information on related matters. Once the publication is announced, these details will be widely advertised on various platforms to again inform key stakeholders of the details. There is also a telephone line already available for people seeking details of counselling support available to those affected by these issues. All of these numbers have been provided to former residents and their supporters and will be publicised on the websites of my Department and the HSE. My officials have liaised with the national counselling service to ensure that capacity is primed to respond to any increased demand for the service which may arise on foot of publication of the report, both during office hours and in respect of an out-of-hours service.
I want to be as clear as possible on the matter of records. The archive of the commission of investigation is still in the commission's possession. The Government's intention is to publish the commission's report as soon as possible. As such, the archive will not be transferred to my Department prior to the publication of the report. This means that I will not be able to provide copies of personal data to survivors in advance of receiving the archive. The archive will be transferred to my Department by 28 February next, as provided for in the legislation. Thereafter, my Department will be able to process subject access requests from people who want access to their records. My Department is working intensively to ensure that it is properly resourced to handle subject access requests and can provide people with as much personal data as possible.
I cannot make an absolute commitment that the Department will be able to provide unredacted records in all cases. As we discussed during the debates, the right to personal data under Article 15 of the general data protection regulation, GDPR, is not absolute. Release of personal data must not adversely affect the rights and freedoms of others, and this test must always be applied when considering whether to release personal data. It is a legal requirement to apply this test in each case and in some circumstances, this is likely to mean that certain records may be redacted or partly redacted.
In all my engagements on the commission's records, I have always been clear that applying GDPR will not resolve all issues around access to information. This issue underlines the importance of enacting robust information and tracing legislation. I have given a commitment in this regard to bring forward fresh proposals on information and tracing next year. The intention is that the legislation will support individuals to access more information than is currently accessible to them under GDPR or the Freedom of Information Act. I am committed to this legislation to ensure that we can provide people with the identity information they need, with the necessary wraparound supports for all involved. I will meet with my officials about the specific legislation later today and look forward to working with all Senators in advancing the legislation.
The two Senators have a minute between them to respond.
I will be brief if I only have 30 seconds. I thank the Minister for his reply. It is welcome that the free phone telephone numbers are there and that supports are being put in place. I am going to move briefly to the final part of the Minister's statement which related to the information and tracing legislation. He flagged that when he came before the committee in October. It is a priority for the Government and I hope it is legislation that will be progressed in the first half of next year, if at all possible. I appreciate that I did not flag this in advance but if the Minister and his colleagues in government could raise the issue of the archive and Sean McDermott Street, it would be a welcome development in terms of the general issue - not so much for the individual survivors but for history's sake and the State's reparation.
I thank the Minister. It is reassuring that there will be adequate supports and that he has ensured that the counselling services have upped their capacities. I reiterate the care and consideration that is needed. These women have been through horrendous abuse. Their children have been torn from them and their lives were changed forever. The Minister must remember that when he takes any action.
I absolutely agree. I acknowledged during the debates on the database legislation that I had not done enough to engage with survivors. Since then, I have had approximately 40 calls with survivors, individuals and representative groups, which has given me a much greater perspective on the individual harm that was initially done in the mother and baby homes and how the treatment by the State over the years has magnified that harm. I am conscious of those issues and the need to bring forward legislation. It is an absolute priority for me. My officials and I are meeting about it today. I will be engaging in the first place with the Attorney General to talk about the specifics of the legislation and the need to have it focused on GDPR. That will be the linchpin for this piece of legislation and hopefully it will avoid some of the constitutional difficulties on which we touched during previous debates that have blocked progress on this matter.
I will, at all times, be working with Senators and Deputies because we all know that we need to get this right. I am very much looking forward to working with everybody to get a resolution for the women and children who were in these institutions.
National Planning Framework
I appreciate the Minister of State coming here today. It has been quite a while since we met in County Kilkenny. I congratulate him on his elevation to this great office.
The Project Ireland 2040 plan goes a long way back and much work has been done on it. Its inception was to iron out some of the problems that may have arisen in the previous plan. It is not just from a development point of view but I fundamentally believe there are serious cracks in this plan, which will unfold in an extreme manner over the next year or two.
I will give one example where I was contacted by a Longford-Westmeath constituent. The Minister of State is familiar with a town called Castlepollard in which there was a development called Cluain Mullan, which is an estate of 30-odd houses. The developer built out his first section of 22 houses and followed on with another eight houses. Between social housing and affordable housing, Westmeath County Council and the community benefited by approximately ten houses out of that 30, which was a great success.
Part of the field, however, was heretofore zoned. It was de-zoned under the previous monster plan to de-zone all these lands that were not in use. This shows an example of a builder who was on a site building but whose lands were de-zoned. He is the only active builder in Castlepollard at present. It is a provincial town, which are graded on their size and development. It is called a grade 3, or category 3, from a development point of view.
This guy can build; he has the wherewithal and he is on site. The development plan has come up in County Westmeath; that is my example. He has perhaps four acres left in his field, which was previously zoned but has been taken out. The councillors in Westmeath sought to put it back in, and under the new national framework, Westmeath County Council has said there can be no further developments in towns such as Castlepollard, Kinnegad or all these different towns.
The amount of stuff that has been rejected includes small, piecemeal sections of lands that councillors have sought to zone but have been told "No". This is fundamentally wrong, particularly where a developer is on site building and working with the community. This is crazy; we will never build anything. If they were seeking to build somewhere out the road or elsewhere, well and good, but as part of our greater plan we are trying to encourage people to build in towns and villages.
I am surprised, given the Minister's Green Party background and the areas in which he has been active. I have followed much of the work he has done over the years. This, however, is a no-brainer to get people into settled areas where they have sewerage, water and all the facilities. The councillors had to vote against this, of course, to vary the plan. It will now have to go to the regulator to examine it under the new Act and, possibly, onto the Minister. I do not know. I believe the regulator makes the decision and, perhaps, the Minister looks at it from there.
That is just one example, aside from getting onto one-off housing or anything to that effect. There is, therefore, a fundamental problem if reasonably large towns such as Castlepollard, Moate, Kinnegad or Delvin, which have what were naturally zoned sites in infilled sites, cannot develop in particular sites. The Minister of State will have to review this plan because we said we will build 550,000 houses by 2040.
The Senator's four minutes are up.
Over the last number of years, we built between 15,000 and 18,000 houses. We will have Covid-19 this year and it will be something similar.
I must ask the Senator to wrap it up.
I thank the Acting Chairman. I am finished now. We will not hit the target. Unless we look at villages and town such as these and ease up in settled areas, there will be a serious problem and it will come back to haunt all of us. It is evident in the housing market already.
I will address the national planning framework, NPF, first, if that is okay, because my understanding was that the question particularly related to one-off housing. I will, however, specifically reference the issues the Senator spoke about.
First, to clarify, the national planning framework does not either remove one-off local needs planning for rural houses or impose rezoning or de-zoning population caps. The national planning framework provides important national rural planning policies supporting the growth and regeneration of our rural areas, including new housing for local communities. National policy objective, NPO, 15 of the NPF fully supports the concept of sustainable development of rural areas by encouraging growth and arresting decline in areas that have experienced low population growth or decline in recent decades, such as the Senator spoke about.
NPO 15 is supplemented by national policy objective 19, which aims to ensure that a policy distinction is made between areas experiencing significant overspill development pressure from urban areas, particularly within the commuter catchment of cities, towns and centres of employment, and other remoter and weaker rural areas where population levels may be low or declining.
I consider that these NPF objectives represent a balanced approach, consistent with long-standing Government policies on sustainable development and previous planning guidelines. Under the sustainable rural housing guidelines of 2005, planning authorities are required to frame their development plan policies in a balanced and measured way that ensures housing needs of rural communities are met, while avoiding excessive urban-generated housing.
The NPF objectives, together with the 2005 guidelines, therefore, enable planning authorities to continue to draft and adopt county development plan policies for one-off housing in rural areas in a structured and considered manner.
Turning to the anticipated population growth within individual counties, this issue is central to NPF strategy which projects growth in our national population of over 1 million people by 2040. This projection is based on demographic and econometric projections undertaken by the Economic and Social Research Institute, ESRI. To assist in the preparation of individual city or county development plans, over much shorter six-year timelines, an NPF roadmap circular was issued to all planning authorities in 2018, setting out projected county population ranges for both 2026 and 2031.
Importantly, this approach includes minimum and maximum population growth parameters, which provide flexibility to accommodate factors such as lower or higher migration correlated regarding national economic conditions. These projections provide a targeted base for each planning authority to undertake the statutory development plan review process, some of which are now under way across the country.
The NPF population projections provide a coherent approach whereby, in its development plan, each planning authority has clear population growth parameters to consider on the basis for strategic decision making in the formulation of its core strategy, settlement strategy and housing policies generally. Regarding zoning policies, each planning authority retains the decision-making function whereby county level population target ranges may be translated into geographical zones for housing. Planning authorities must consider such decisions in accordance with national guidelines, regional policy and good planning generally, in particular ensuring there is a strong alignment to the facilities and services needed to support local communities and sustainable employment.
To the core of the point raised by the Senator, I believe he is absolutely right. It is correct to say we should be clustering housing, insofar as we can, in and around existing urban settlements to give capacity but also to unlock the potential in our town centres of buildings that are already there. That is core to what the Government is trying to achieve through the "town centre first" policy, where there is access to services and they are walkable and cycleable, give capacity to our shops and are connected into waste water infrastructure.
In answer to the Senator's question, it is important that local authorities strike that balance between achieving good capacity and building the capacity of our town centres. I believe that is the point the Senator raised.
I thank the Minister of State. It was a comprehensive answer but there is a problem, which I can tell him as a fact and he can take it out and look at it. In Westmeath, the zoning happening is mainly in Athlone and Mullingar. In all the regional towns, any little projects like that which could be looked at have not been considered this year. The councillors had to use their practicality and went against better advice, which will now be sent to the regulator because they were not part of the development plan drawn up by the executive.
There is a serious problem and this will happen in counties everywhere. Is the Minister of State seeing this anywhere else?
It is primarily a matter for the local authority and its members to work on the core strategy with the executive. This is the important point. There is a core strategy in the development plan that is able to give capacity to the smaller towns and villages in the county development plan. All of the development plans are aligned at present and making their way through the process. They have to go through appropriate assessment and the checks and balances that meet national planning framework guidelines. At the core of this is that the local authority needs to strike a good balance to ensure all towns and villages are given the capacity to grow in a sustainable way.
The national planning framework should be tweaked more towards those smaller towns and villages. They are not part of it. They are numbered and categorised but they really are the orphans in this process. I refer to towns such as Castlepollard and Kinnegad. They should get more priority. We should look at this. It is within the remit of the Minister of State.
Will the Minister of State make a statement on the recent and ongoing issuing of deportation orders and letters to asylum seekers requesting that they leave the country voluntarily or be threatened with deportation? Will he make that statement in the context of the global Covid-19 pandemic? Our obligations in terms of international protection have never been as important as they are now given the global emergency that is happening. We know that the UN High Commissioner for Refugees, UNHCR, the International Organization for Migration and the UN World Food Programme have all reported the massive exacerbation of pressure on vulnerable peoples throughout the world due to the Covid-19 pandemic. As of August, 79 million people had been displaced globally because of the pandemic. These are the figures from the UNHCR. It is a global crisis.
I am extremely concerned that 469 deportation orders have been issued since March. I have received very concerned queries from a number of international protection applicants and from their communities. At a time we are told travel is to be restricted, the receipt of a letter telling people they need to leave the country or they will face the threat of deportation or they might be deported at any moment is deeply distressing not just for the individuals but for their partners, their families and the communities in which they are involved. Many of those receiving these letters are very active in their communities. They are community volunteers. Some of them are extremely talented artists. We know that some of them are health workers or care workers. We have people who are part of the fabric of communities trying to help those communities through difficult circumstances and a letter like this adds great distress.
What is the rationale behind the issuing of such letters and deportation orders during a global emergency? What considerations have been given to the principle of non-refoulement, which is that people should not be deported into a situation where their lives may be threatened due to various factors such as their race, religion, nationality, membership of a particular social group or a political opinion, if it is the case that these categories would lead to somebody having difficulty accessing health services, or that the very process of being forced to travel during a pandemic could endanger somebody's life? There is a real concern about the absence of protection and the lack of access to necessary healthcare and protection if we are sending people into those circumstances and, in some cases, into very overburdened health systems.
The Taoiseach has indicated with regard to a particular case where two healthcare workers were issued with deportation orders that they would not be deported to Covid-19 hotspots. Is this the Taoiseach's statement or a departmental policy with regard to deportations? Are other considerations being made with regard to these orders and the risks of international travel?
Either by means of statutory instrument or legislation, I urge the Minister of State to indicate how he intends to engage on this issue? Will he look at a cessation of the issuing of deportation orders during the Covid-19 pandemic or at least during emergency periods such as we are in at present? Will he look at statutory instruments or legislation, including, potentially, the powers he might have under the Health (Preservation and Protection and other Emergency Measures in the Public Interest) Act? There might be an opportunity under those powers to take action on this issue and ensure we stop this practice.
I thank the Senator for raising this important matter, which I am taking on behalf of the Minister, Deputy McEntee. The Minister is aware that it has been a cause of significant concern in recent weeks.
I assure the House that our objective is to have decisions made as soon as possible on international protection applications and permission-to-remain considerations. This approach means that those who are found to be in need of protection will receive it quickly and can begin rebuilding their lives here with a sense of safety and security. For those found not to be in need of protection, we can offer them assistance to return to their home country. This objective of timely decision making is shared by the expert group led by Dr. Catherine Day, whose report the Ministers for Justice and Children, Equality, Disability, Integration and Youth, Deputies McEntee and O'Gorman, published recently.
For those found not to be in need of international protection a full consideration of all aspects of their case is considered before a deportation order is made. This includes a full consideration of their private and family rights in accordance with the European Convention on Human Rights as well as consideration of their work situation, among other issues. The principle of non-refoulement applies to these decisions. Under international human rights law, the principle of non-refoulement guarantees that no one should be returned to a country where they would face torture or cruel, inhuman or degrading treatment or punishment and other irreparable harm.
During the early stages of the pandemic, it was decided to issue positive recommendations only from the international protection office. The aim of this approach was to ensure applicants with negative recommendations were not disadvantaged by the time limits set out in the legislation within which they must make an appeal or request a review of a refusal of permission to remain. Once substantive processing and appeal hearings recommenced in more recent months, so too did the issuing of negative decisions. While the number of negative decisions did not increase, there was a build-up in the issuing of such decisions, with a higher volume than normal issuing once processing recommenced.
When individuals are advised of their negative international protection decision they are informed that they no longer have permission to remain in the State. Under the relevant primary legislation on this issue, they are required to confirm within five days if they will accept the option of voluntary return, for which the Department of Justice will provide assistance. If they do not confirm that they will leave voluntarily, a deportation order will then be made against them.
That said, a pragmatic approach is taken and, to be clear, the person is not required to remove themselves from the State within five days, they are required to indicate an intent to do so. The time taken for relevant voluntary return arrangements to be made will take into account all factors, including Covid restrictions and the limitations to travel this has created. Having said that, the Minister has previously stated that particular issues clearly arise with level 5 restrictions and, as a result, the letters may have inadvertently caused distress. The Minister, therefore, asked her officials to review the process of issuing such letters during the restrictions. I understand that no letters have issued since.
The expert group led by Dr. Catherine Day has recommended that the five-day period for deciding whether to accept voluntary return should be extended to 30 days. This, along with all other recommendations relevant to the work of the Department, will be actively considered by the programme board that the Minister has established for this purpose. Its work will feed into the development of the White Paper by the end of this year, in line with the programme for Government commitment.
I strongly suggest that the Department return to the position of only issuing positive decisions during this period. Those who might be required to appeal cannot engage with the community or seek support if people cannot visit households.
I am aware that people have been deeply distressed to have friends who have received deportation orders and who have not been able to engage with or see how they might be able to support them. I suggest strongly to the Minister of State that he formally return to the policy of only issuing positive decisions. I also suggest that the 30-day requirement, as proposed in that report, be implemented and that there should be a cessation in the issuing of these letters during that period until that 30-day period is set in place because a five-day notice landing in the middle of a lockdown level 5 is too distressing for people.
I appreciate that there are pragmatics but it is important that there is a clearer policy for those who receive letters. They often cannot even seek legal advice in that time. Can the Minister of State formalise the more humane policy that was adopted earlier in the crisis?
I thank the Senator again and I acknowledge her request on positive decisions only and bringing in the 30-day requirement as soon as possible. I will bring both of those proposals to the Minister. I reiterate that each case is examined in detail on its individual merits taking all of the factors into account. I assure her, however, that I will convey all of her comments to the Minister today.
I thank the Minister of State, Deputy Browne, for his attendance.
Sexually Transmitted Infections
Cuirim fáilte roimh an Aire Stáit, Teachta Feighan. I thank him for attending.
Míle Buíochas, a Chathaoirligh Gníomhaigh. I welcome the Minister of State to the House today, on World AIDS Day. This is a worldwide health day with the theme of global solidarity and shared responsibility in fighting the stigma of HIV and AIDS in our country and in the world. I tabled this matter and I thank the Cathaoirleach for allowing both myself and Senator Warfield to raise two different Commencement matters on World AIDS Day on sexual health strategy, which for the current five-year period is about to expire. I hope it does not just run out and that the next strategy is consultative because it is important that we renew our focus on tackling HIV through rapid testing, accessibility and collaboration between all the stakeholders involved and the NGOs. In particular, I pay tribute to the sexual health clinic in Cork and HIV Ireland for the work that they are doing. I also want to thank the State agencies under the remit of the Minister of State and to compliment him on the work that he is doing as Minister of State in the time that he has been in this position. I know that he has been very proactive on this particular issue.
The sexual health and crisis pregnancy programme has helped to fund and provide seed capital to meet our aspirations under Healthy Ireland to tackle the stigma of HIV and to reduce the numbers. The rates for this year are on a par with previous years and there is a worry about the trends. Our focus must be on achieving the goals and on maintaining funding. As a country we have signed up to Fast-Track Cities, the global partnership with the 90-90-90 outlook and outcome, and we all must be committed to making testing easier in order that we can all know our status, with community testing made available, as well as to raising awareness and reducing the stigma that still exists in the context of HIV.
In the context of Cork, I pay tribute to the staff and leadership of the Sexual Health Centre who are doing Trojan work during this pandemic with the outreach, support programme and counselling that has been available. Their HIV sexually transmitted infection, STI, clinic has been open throughout the pandemic. It is a facility and service available to people and the clinic must be commended on this.
Our urban centres may not be an issue - Senator Warfield will have a Commencement matter on a particular issue shortly - but visibility in rural settings is one that needs to be addressed as to equity of service, and availability and access to services. I was asked by somebody whether an Eircode postcode was the decisive feature in access to service. I certainly hope that it is not.
I also commend HIV Ireland, which has been to the forefront in our battle and response to HIV and AIDS for more than four decades. In reflecting, as many of us do, and remembering our many friends we have lost, we recognise today that we are in a better place as a country because in the furtive early years, a social policy was being led and changed by NGOs and activists. Today, this is now Government-led. That is why the red ribbon, the symbol of HIV-AIDS awareness, is one that we should be proud to wear. I thank the Minister of State for being present and I look forward to his response. Our journey continues and I am very proud to see that he is present to wear the jersey in this battle and quest. I genuinely believe that we are lucky to have him as Minister of State as I know him a long time as a person with a genuine commitment to people.
I thank the Senator for his remarks. The national AIDS strategy referred to by the Senator was published in 2000. Its most recent successor is the National Sexual Health Strategy 2015-2020, published in 2015. That strategy aims to improve the sexual health and well-being of the population and to reduce negative sexual health outcomes, including unplanned pregnancies and the transmission of STIs, including HIV. These aims are being addressed by the delivery of a programme of work to improve education and prevention supports, sexual health and STI services, and the quality of health information used to inform policy. The vision of the sexual health strategy is "that everyone in Ireland experiences positive sexual health and wellbeing". The strategy has three goals: that everyone living in Ireland will receive comprehensive and age-appropriate sexual health education and/or information and will have access to appropriate prevention and promotion services; that sexual health services, which are equitable, accessible and of high quality, will be available to everyone; and that robust and high-quality sexual health information will be generated to underpin policy, practice, service planning and strategic monitoring.
A mid-term review of the strategy in 2018 found that implementation is going well. There is a great working relationship between voluntary and community groups working in this area, and the HSE's sexual health and crisis pregnancy programme, SHCPP, which manages the health care services covered by the strategy.
Tackling the recent increase in new diagnoses of HIV and other STIs is a key element of the strategy. Last year saw the launch of a number of major actions to combat these rising rates of infection. In June 2019, Ireland formally became a member of the HIV Fast-Track Cities initiative, a major global partnership committed to accelerating local HIV-AIDS responses. Dublin, Cork, Limerick and Galway have joined this network, and €450,000 in funding was provided in 2019 for implementation of local actions, such as increased access to HIV testing. The most significant development in 2019 was the introduction of a national programme of HIV pre-exposure prophylaxis, or PrEP, which involves the pre-emptive use of anti-retroviral medication to prevent HIV infection.
PrEP is provided within a holistic prevention service which includes regular monitoring and testing, as well as advice and counselling on safer sex practices. Funding of €5.4 million was provided in 2020 to provide for a full national roll-out of PrEP and to fund additional staff and other resources required to provide HIV PrEP within a broader sexual health and HIV prevention programme.
Other important actions undertaken by the SHCPP includes support for parents, with a range of booklets having been published recently to enable them to talk to their children about relationships, sexuality and growing up. The SHCPP also provided support for the provision of relationship and sexuality education in schools. The programme plays a vital role in developing research, collaborating with, for example, the ESRI, to produce the evidence-based information that is vital to understanding emerging trends. The future direction of the strategy will be reviewed in 2021.
I thank the Cathaoirleach Gníomhach and the Minister of State.
It is important that we live up to our expectations around fast-track cities, that there is a combined collaborative approach and that we continue to be to the forefront in responding to HIV and AIDS.
The funding of €450,000 announced last summer needs to be matched in future years. I hope that community-based testing, outreach services, public awareness campaigns and the availability of PrEP continue. They are very necessary. The elimination of stigma, increasing education and awareness and the continued promotion of young and not so young people is important.
Some 23 public STI services nationally provide free STI and HIV testing. HIV testing is also available as part of the national antenatal screening programme, with almost 100% uptake. The HSE sexual health and crisis pregnancy programme funds and collaborates with community partners to expand HIV testing among higher risk population groups such as gay men and migrants in order to identify those living with undiagnosed HIV. The two most important partners are HIV Ireland and the Gay Health Network. I was delighted to meet HIV Ireland yesterday at the launch of another facility in the Mater hospital in Dublin.
HIV Ireland is funded to support a programme called mPower which provides testing and outreach support to gay and bisexual men online and in a face-to-face capacity. Funding is also provided to the Gay Health Network to manage the man2man.ie website, communications messaging and campaigns to ensure that gay men have access to the appropriate information on sexual health and available services. Further information and links are also available through sexualwellbeing.ie.
I note the importance of World AIDS Day in raising awareness of this illness which is a key element in keeping infection rates as low as possible. We will continue to work as closely as possible with all of our key partners and stakeholders in this important area in order to make the best use of resources and continue to fight against HIV and, as Senator Buttimer said, stigma.
I thank the Minister of State for coming to the House today. I feel like we have a weekly date to discuss things.
It probably goes without saying that this year has been an extremely difficult and trying time for everybody in the country, but for none more so than our front-line workers, in particular those working in the healthcare system, including our doctors, nurses, porters, cleaners and healthcare assistants. It has been tough for them and in uncertain circumstances they have stepped up to stop the pandemic in its tracks, help and mind Irish people and ensure our hospitals were not overrun, as unfortunately happened in many other European countries.
Student nurses in many of our hospitals continue to be a vital additional resource for management when workloads increased. The Department of Health correctly opened the temporary healthcare assistant salary to student nurses who carried out the duties, and, more important, had the responsibilities of looking after our fellow citizens, responsibilities that would never have been placed on them in any other, normal year.
For a student nurse studying for a four-year degree, 45 weeks of placement are required. While the four-year internship programme and placement are paid, students in first, second and third years are unpaid. In the past week or so, different commentators and the Minister have tried to justify the receipt of travel or accommodation allowances, but at the very best that payment might equal €50 per week. At the very worst, a young woman in my constituency detailed that she gets €7 per week in travel allowance. That would not cover her bus fare from Ratoath to the hospital she is working in. Significant asks have been made of student nurses this year, and they are not going away and probably will not go away until we have a widespread vaccination programme which will come, please God, next year.
Gaining a qualification in nursing is a daunting enough task at the best of times. Doing a placement in the middle of a global pandemic with many incredibly worrying and overwhelming challenges ahead of them means that we need to show we value the students and the work they do. To do that, we need to compensate them. We need to recognise, through money, our support for student nurses and the work they do. A round of applause would only go so far.
I welcome the recent soundings from the Minister and Department of Health on reviewing student allowances in the longer term. That the Minister is considering those proposals means that will not help students on a placement this year. Students who have been on those placements from September until Christmas will be expected to come back in January when we know the normal onslaught on the health service will put them in a further invidious and unenviable position.
It is time for us to stand up as a State and recognise once and for all, not at some future date but today, the hard work, commitment and dedication to the delivery of good public services and health services shown by our first, second, third and fourth year student nurses, and make an announcement before Christmas that we will look after them financially.
I thank Senator Doherty for raising this important issue. I recognise the importance of student nurses and midwives completing their essential clinical placements in a safe environment and the potential hardship that might arise for students on placement due to Covid-19, as the Senator outlined, such as maintaining part-time employment, increased travel and additional accommodation costs.
Student nurses and midwives are not paid for clinical placements in years one to three, inclusive, and year four from the period of September to December of their studies. This supernumerary status is critical for learning in complex environments. Financial supports for non-intern student nurses and midwives are governed by Circular 9/2004 which provides for an accommodation allowance of up to €50.79 per week to be paid where it is necessary for a student to obtain accommodation away from his or her normal place of residence and a refund of travel expenses. Both are paid as refunds on production of receipts.
Concerning fourth year nursing and midwifery students, the HSE continues to fund the internship employment of these students who are on rostered work placements. This includes those due to commence rostered work placements in January 2021. These student nurses and midwives on rostered work placement are paid at the approved rate, that is, €22,229 on an annual basis for psychiatric nursing specialism and €21,749 for all other nursing disciplines and midwifery. These rates of pay are determined by HSE Circular 005/2016 and are the updated rates in accordance with the consolidated pay scales with effect from 1 October 2020.
In the immediate term, my Department reviewed a number of supports that applied to this year's supernumerary students which includes first, second and third year students and fourth year students from the period of September to December on clinical placements, taking into account the impact of the Covid-19 pandemic on such placements.
Other supports available in 2020 for student nurses and midwives include access to the pandemic unemployment payment for those students who may have lost part-time employment due to Covid-19; enhanced illness benefit for those students who work part-time but have fallen ill with Covid-19; other welfare schemes to assist with financial hardship due to illness, subject to qualifying criteria, for example, the supplementary welfare allowance and the urgent needs payment; access for eligible students to the national access plan contingency fund and the student assistance fund; and a €250 top-up for those in receipt of the Student Universal Student Ireland, SUSI, grant or a €250 contribution to fees to eligible students. Details of these schemes can be obtained from the Department of Social Protection.
Separately, and for the longer term, the Department is continuing with its review of the current accommodation and travel allowances payable to students on clinical placements. The outcome of this review will apply from the academic year commencing in autumn 2021 onwards. I look forward to examining the outcome of this review in due course.
I am nearly lost for words. I thank the Minister of State for coming to the House to give us an update. He stated that we are going to compensate young women and men for not going to work in Captain America's on a Friday night so that they keep themselves safe and can go into the Mater, St. Vincent's, Blanchardstown and Drogheda hospitals to provide a service.
We are going to compensate these young people if they get sick but we are not going to give them a few bob for the work they are doing in keeping our citizens safe and our hospitals running and ticking over in the manner which we have enjoyed for the past ten months. We have had a system for the delivery of healthcare because of every cog in the wheel working. Our student nurses, from first to fourth year, are an integral part of that cog. By Jove, if they walked out tomorrow, we would know how much work they are actually doing.
Will the Minister of State tell the Department to review the health care assistant contract for autumn next year? While it might be welcome for the nurses then, it will do nothing for our young people working in the public health care system today. I am pleading with the Minister of State and the Minister for Health to re-evaluate, acknowledge and accept the dedication and hard work of these student nurses, as well as the learning in our hospitals. We must recognise with more than a round of applause the hard work being done by these young men and women.
I thank Senator Doherty for raising this important issue. I reiterate our gratitude and pay tribute to student nurses, midwives and their healthcare colleagues who continue to deliver care right across the system during this unprecedented time.
The past nine months have demonstrated, more visibly than at any other time in our recent history, the dedication, skill and commitment of our healthcare workers. I am acutely aware that this was not without risk, particularly for everyone on the front line. In order to protect the education of these students, I look forward to bringing forward the details of the work under way within the Department when it is complete.
I will bring this back to the Minister to get it expedited. This issue is very much on the minds of many people. We hope the Department can look at this more favourably than this response.
Health Services Provision
I want to begin by acknowledging World AIDS Day, which the Minister of State has done. I want us to remember, grieve and celebrate all the people who were claimed by the disease. More than 35 million people have died from AIDS-related illnesses since the beginning of that epidemic. I want to acknowledge the emotional cost to the many who survived and dodged the virus as they watched, counted and stopped counting the number of their friends and chosen family who were claimed by the disease.
I was in Áras an Uachtaráin on World AIDS Day in 2017 when the President, Michael D. Higgins, said, "Those who suffered the most in the 1980s were those exposed not only to a prejudice born of misunderstanding of HIV and AIDS, but also to other forms of social oppression which were, and are, too often manifested in our society." So many of the people I am proud to remember fought incredibly hard for many of the services that we have today. They also fought incredibly hard for the right to live free from the church and State, along with the right to access services such as the one I have asked the Minister of State to make a statement on today.
These types of services are incredibly important. Last year, there were 536 new cases of HIV in Ireland. According to HIV Ireland, men who have sex with men are the group most affected by HIV in Ireland, accounting for 56% of diagnoses in 2018. However, the Gay Mens Health Service, GMHS, is the only sexual health service which has not reopened. The sexual health services which are open are oversubscribed. The closure of GMHS will have an impact on the transmission of HIV and sexually transmitted infections, STIs, which will disproportionately affect gay and bisexual men.
Will the Minister of State do everything he can to help GMHS to reopen as a matter of priority? Between 15 and 20 LGBT organisations have written to the HSE and launched a petition live online on this matter.
I thank Senator Warfield for raising this issue. I am aware of the petition which has been launched.
Sexual health is a priority for the Department of Health. This was evidenced by the publication of the National Sexual Health Strategy 2015-2020, the first major strategy to tackle this vital area. We have made good progress with implementation of the strategy since 2015. The Department of Health, along with the HSE's sexual health and crisis pregnancy programme, have worked hard to build important partnerships with a range of community and voluntary groups, all of which are working with us to implement and progress a range of important sexual health initiatives.
One area of concern to us all continues to be the rise in new diagnoses of HIV and other STIs. Last year saw the launch of several major actions to combat these rising rates of infection. These actions include Ireland joining the HIV Fast-Track Cities initiative, which includes enhanced access to HIV testing, along with the roll-out of a national HIV pre-exposure prophylaxis programme, which involves the pre-emptive use of low dose anti-retroviral medication to prevent HIV infection.
The Covid-19 pandemic has led to unprecedented interruptions to normal healthcare activity with most services affected, including STI clinics. Virtual clinics are being deployed where possible with attendance in person limited to appointment only. Service restrictions are predominantly due to social distancing requirements as waiting rooms can now only hold a fraction of patients compared with before the pandemic. Priority is being given to those with symptoms or requiring testing and treatment.
I am advised by the HSE and community health organisation, CHO 6, that the closure of GMHS relates to the necessary redeployment of personnel to Covid-19 testing and contact tracing duties. Work is ongoing with other services, stakeholders and community groups in order to provide the best possible service to GMHS service users under the circumstances.
Agreement has been reached with St. James Hospital's genito-urinary infectious diseases clinic, GUIDE, that all GMHS pre-exposure prophylaxis programme users will be facilitated there for follow-up appointments. Phonelines, the GMHS website and other resources such as man2man.ie and sexualwellbeing.ie are regularly updated to reflect current service delivery and to signpost users to the HSE list of approved pre-exposure prophylaxis programme services.
At a national level, the HSE advises that staff recruitment is ongoing with regard to the dedicated provision of Covid-19 services. It is envisaged that this will enable staff redeployed to Covid-19 related duties from other health services, including GMHS, to return to their respective positions and resume service delivery as soon as the circumstances permit.
The Minister of State will appreciate that the HSE has been talking about staff recruitment for a long time. If he cannot answer it now, he can write to me. Who is responsible? Is it senior management in the HSE or CHO 6 which is responsible for GMHS reopening? Is the agency responsible committed to its prioritisation for its return? What is the actual update on Covid-19 recruitment? When will the Covid staff be hired and when will GMHS staff be freed up and the service reopened? Will this be a priority once staff for Covid-19 testing are hired?
I would like to highlight, in more detail, some of the recent actions of my Department and the HSE with regard to tackling HIV infection.
The most significant development in 2019 was the introduction of a national programme of HIV pre-exposure prophylaxis which involves the pre-emptive use of anti-retroviral medication to prevent HIV infection within a holistic prevention service which includes regular monitoring and testing, as well as advice and counselling on safer sex practices. Funding of €5.4 million was provided in 2020 to allow full national roll-out and to fund the additional staff and other resources required to provide the HIV pre-exposure prophylaxis programme within a broader sexual health and HIV prevention programme.
These are landmark programmes and welcome additions to our work in reducing the number of people who contract HIV in future. I reiterate our intention to reopen GMHS as soon as the Covid-19 circumstances permit.
I appreciate people are anxious to get these services open as quickly as possible, as are the staff in the Department and the HSE. I thank the Senator for raising this important issue.