I welcome the Minister of State at the Department of Health, Deputy Butler, to the House. We begin with Senator Sherlock's Commencement matter.
Nithe i dtosach suíonna - Commencement Matters
Health Services Staff
Go raibh maith agat, a Leas-Chathaoirligh. I welcome the Minister of State and thank her for coming to the House.
A year, a week and a day ago, the Minister for Health announced that there would be 24 new lactation consultants appointed in 2022. My simple question to the Minister of State is: where are they?
I must credit the wonderful campaigning group, Bainne Beatha, for alerting us to the date last week. When the announcement by the Minister was made last year, we very much welcomed it, but from talking to campaigners on the ground, there is a real question mark now as to where exactly are those posts. Have people been appointed?
As the Minister of State will be aware, the scale of the challenge is enormous if we want to improve breastfeeding rates in this country. It is about improving the interventions; it is about improving the peer-to-peer experience and it is about improving the culture, both within hospitals and within the community.
It is really important to acknowledge that it is every individual family's right to decide how best they want to feed their own baby, but it is those women and families who want help and who have been seeking help but have been so badly let down by the public system that we really need to help.
According to the Irish Maternity Indicator System National Report 2020, breastfeeding was initiated after birth for 62.3% of babies born in 2020. That is a decent number. That falls to 58.5% either exclusively breastfeeding or combination feeding upon discharge of hospital. Within six months, that falls to approximately 15% of babies.
There is a real failure, both in hospitals that we would see any drop in breastfeeding rates between when a baby is born and upon discharge, and then, of course, when women are back within their own communities.
I suppose the failures are that we have considerably inconsistencies in hospitals with regard to culture, practice and availability. I was talking to a woman the other day who was telling me of how she struggled trying to feed and, unknown to her and without her permission, her baby was given a bottle of formula when she happened to be asleep. This was only two years ago in a national maternity hospital; that is disgraceful. The hospital has yet to acknowledge that such an incident happened and yet two beds over, a woman had a completely different experience and does not recognise that other lady's terrible experience at all. We have situations where the master of a maternity hospital and the ward sister are walking around telling mothers to put away the bottles that are on their shelves and hiding that babies are being fed formula.
Of course, there are issues with the availability, particularly at weekends, of lactation consultants. We know from the Bainne Beatha survey last year of women repeatedly making requests for a lactation consultant within the hospital, yet those requests went unheard. We accept we have had Covid and all that, but this is not a new phenomenon. This has been going on for many years.
Within the community, I am still hearing varying experience with regards to the service and advice, in particular, that public health nurses are providing. I am told within CHO 9, within Dublin north city and county, that all 22 public health nurses have received breastfeeding training, yet I know on the ground that there are some public health nurses actively advising mothers to give up breastfeeding and that there is an easier way.
Do we have these new posts on the ground and what is being done about training those who are in really important roles with vulnerable mothers at an important time in their lives?
How does the Government propose to improve the situation?
I thank the Senator for raising this important issue. I am delighted to be here, as a woman, to discuss this. The Senator focused on one line which she said was important. It is up to each family to make the decision and the Senator is clear on that. We agree that it is important the family make the best decision for the mother and baby.
I am answering this on behalf of the Minister, Deputy Stephen Donnelly. The promotion, support and protection of breastfeeding is a priority for children's health in Ireland. Breastfeeding in a Healthy Ireland: Health Service Breastfeeding Action Plan 2016-2021 is the framework for progressing supports for breastfeeding. The HSE is partnering with key divisions to provide the supports that mothers require at all stages of the breastfeeding continuum. The Deputy is right that if that decision is taken, it has to be understood that the supports are there. Some people find it difficult and some find it easy. We all know of cases where people give up in frustration even though they want to continue to breastfeed.
Due to the impact of the Covid-19 pandemic on the delivery of some actions, the HSE will extend the implementation of the breastfeeding action plan into 2023 and continue to work on the priority outstanding actions. Ireland has a culture of bottle feeding and, in order to improve child and maternal health and reduce childhood obesity, we need to improve our breastfeeding rates.
While breastfeeding is the most natural way to feed the baby, it is a skill that mother and baby develop over the first days and weeks. With the right help, support and information, most mothers can start breastfeeding and continue for as long as they want to.
A combination of interventions at public health, public policy, clinical and community levels are the most effective way to support mothers to breastfeed for as long as they wish. Evidence-based interventions at clinical level include changes to policy and practice within hospital and community settings in line with best evidence on practices that support optimum infant feeding in maternity, paediatric, and community services. Integrating routine lactation consultant support improves the experience of care that mothers receive, along with breastfeeding initiation and duration rates. Midwives and public health nurses are trained in supporting breastfeeding, commencing in the antenatal period with the delivery of antenatal breastfeeding education. Midwives support antenatal education and help mothers to establish breastfeeding in the early days. Public health nurses, many of whom are midwives and paediatric nurses, continue to support breastfeeding mothers through the postnatal period. Every mother is visited by a public health nurse within 72 hours of leaving hospital. Breastfeeding mothers receive follow-up support if needed.
Until 2020 the implementation of the breastfeeding action plan was undertaken within existing HSE resources. The Minister for Health has advised me that a total of 34.5 new infant lactation posts were approved through the national maternity strategy and the Department between 2020 and 2021 to ensure every maternity unit and community health service will have dedicated posts in place. The HSE, most importantly, has recruited a national lead at the end of 2021 to support implementation of national infant feeding standards within maternity services.
To answer the Senator's main question, of the initial 10.5 infant feeding posts approved through the national maternity strategy, eight are currently filled and recruitment continues for the remaining 2.5 posts. The Minister for Health announced funding for 24 additional infant feeding posts in May last year, with funding for these permanent appointments confirmed in the national service plan 2022. Following sign-off of that plan, primary notifications for these positions have been secured and recruitment has commenced. I have requested the HSE to provide specific details on the recruitment campaign, and this information will be forwarded when it is available.
I have a list of where the 8.3 posts are in place and can share it with the Deputy after this debate, if it is helpful. There are currently 8.3 whole-time equivalent posts working in community services and 14 of the 24 new posts announced last year are allocated to community services to ensure that every public health nursing service has dedicated breastfeeding supports within their service. The breakdown of the allocated posts is 14.5 for community services and 9.5 for maternity services. I can share the information with the Senator afterwards. I have a breakdown of which counties it is currently being provided in.
I thank the Minister of State. Maybe I am of a simple mind but either the 24 posts have been recruited and filled or they have not. The Minister of State is saying 14.5 of the 24 posts have been allocated to community services but that is a budgetary allocation. Either the people are providing the service or they are not. Will the Minister of State take back to the Department that we need to see clarity? At this time on a Wednesday morning, are new, qualified lactation consultants providing support to breastfeeding mothers or not, compared to this time last year? I am not sure this answer has shed any greater light on that.
Of the initial 10.5 infant feeding posts approved through the national maternity strategy, eight are filled. Cavan-Monaghan, Clare, north Tipperary, North Lee, and Longford-Westmeath have one each; west Cork has 0.8; south Tipperary, Wicklow south, Dublin south east, Dún Laoghaire and Wicklow north have 0.5 each. That comes to the 8.3 currently in place and on the ground today.
That is the pre-2020 situation.
It is. Recruitment for nursing-related grades has been challenging, particularly due to Covid-19, but every effort is being made to recruit. The breakdown of the 24 lactation consultant posts is 9.5 for maternity services and 14.5 for community services. I have the breakdown here of where they will be allocated. I am keen, in my role as Minister of State with responsibility for older people, that the postcode lottery has to stop. Regardless of where one lives, one should have access to the service. It should not be that someone living in a big city or town has the service and someone in a more rural area does not. They are actively recruiting so hopefully we will have a further update. I will bring back the Senator's concerns because it is important for new mothers, especially on their first baby when it is all so new to them, to have that support.
I welcome the Minister of State to the House. I raise this on behalf of the 36 children excluded, particularly Eimear and her mom Julie. This is about the availability and accessibility of a life-changing cystic fibrosis drug. A total of 36 children between the ages of six and 11 are being excluded. It makes no sense, as the treatment prevents damage to the lungs. Cystic fibrosis diminishes the quality of life and left expectancy of young children who have it. This new medication Kaftrio allows cystic fibrosis patients to live a fairly normal life. I know of a number of young children who have it and have benefited enormously from this drug therapy. Their quality of life has been enhanced beyond words. It is a vexing issue for the families in question, that is, Eimear, her mom Julie and the 35 other children.
There is the issue of gene mutation not being covered by the HSE. Cystic Fibrosis Ireland, which has done an extraordinary amount of work and advocacy, including on this matter, has asked the HSE and the pharmaceutical company to return to the negotiating table to allow the 35 children to access this life-saving drug. It is a pricing dispute, from what I can gather. More important, this is about enhancing the quality of life of young people, ensuring we do not allow further damage to their lungs and pancreas and, as the Minister of State said, the postcode lottery is eliminated and we allow for accessibility.
Cystic Fibrosis Ireland asks that the children in this case are not used as pawns in a pricing dispute between a pharmaceutical company and the HSE.
We are discussing a difficult issue. If we have learned nothing else from Covid-19, we have learned that we can change how we do business at the flick of a switch. I urge that we do something similar in this case. We should not allow young children and their families to be used a part of a negotiation between the HSE and a pharmaceutical company.
A press release from Cystic Fibrosis Ireland states:
Cystic Fibrosis Ireland understands that Vertex is currently seeking an enhanced price for the 35 children concerned, which is different to the price charged for all other children and adults under the Portfolio Agreement. As a result, we understand that the HSE has been unwilling to accept this price and has instead referred the matter to the National Centre for Pharmaco-Economics (NCPE).
I am sure Professor Barry has a role to play in that as well.
On behalf of the children, their families and Cystic Fibrosis Ireland, I implore those concerned to find a resolution to this matter and to allow access to the Kaftrio drug therapy. This is about quality of life and enhancement of life, and about saying to these children that they can live a life free from worry and concern.
I thank the Minister of State for coming to the House to represent the Minister for Health. I know this is not her area of responsibility. I ask her to convey to the Minister my concerns and those of the families.
I thank the Senator for raising this important issue. For Eimear, her mum Julie and the 35 other children he referred to, this is a very important issue, especially for families with children who suffer from debilitating conditions.
As the Senator will know, the HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes and for the administration of the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority. In line with the 2013 Health Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list. The HSE robustly assesses applications for pricing and reimbursement to make sure it can deliver the best value in terms of each medicine and ultimately make more medicines available to Irish citizens who need them.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds on the advice of the National Centre for Pharmacoeconomics. The NCPE conducts health technology assessments for the HSE and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess a drug's clinical and cost-effectiveness as a health intervention.
The HSE has advised that on 7 January 2022, the European Medicines Agency approved a change to the marketing authorisation for the medicinal product Kaftrio. This change expanded the group of cystic fibrosis patients for which this medicine is now licensed and that is good news. On 21 March 2022, the HSE received a rapid review dossier from the manufacturer for a pricing and reimbursement application for Kaftrio to treat a group of patients aged between six and 11 years covered by the EMA's expanded marketing authorisation. Following assessment by the HSE, and in line with agreed processes, reimbursement is in place from May for these children under the high-tech drug arrangements. The HSE has also advised that another pricing and reimbursement application with respect to Kaftrio for a further group of patients of the same age was received on 11 April 2022 and is currently undergoing assessment in line with the 2013 Act.
The HSE has, to date, engaged in five commercial meetings with the manufacturer between 6 January 2022 and 14 April 2022 to discuss this application. The NCPE rapid review assessment report for the application was received by the HSE on 10 May 2022. The NCPE advised that a full health technology assessment was recommended to assess the clinical effectiveness and cost-effectiveness of this indication compared with the current standard of care. The HSE advises that it commissioned a full health technology assessment on 16 May as per standard process.
To sum up, the Senator was quite right that this all about enhancing the quality of life of these children. A lot of work is under way behind the scenes. Four meetings have taken place, one of which was held as recently as 16 May. I am hopeful and confident that because this drug has been made available to some children who have cystic fibrosis, more progress will be made for the families to whom he referred.
I thank the Minister of State for the encouraging words at the end of her contribution. She is right that the drug has been made available to some people. I believe that others should not be excluded from receiving the drug and hope that progress will be made. As the Minister of State said, there is work under way behind the scenes. I ask her to ask the Minister for Health, Deputy Stephen Donnelly, to meet representatives of Cystic Fibrosis Ireland. The organisation asked to meet him and I hope such a meeting will take place.
As the Minister of State said, we need an outcome that ensures progress continues and all of the affected children can avail of this life-changing, fantastic drug, Kaftrio. As I keep saying, the pandemic has taught us how to change the way we operate and do things differently. I am sure we can apply a pandemic-style approach to this matter to ensure the progress made continues and that access is opened to all.
The Minister for Health appreciates the desire of families to see their children who suffer from this debilitating condition access all potential treatments as soon as possible. However, section 6 of the Health Service Executive (Governance) Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or personal service to any individual or to confer eligibility on any individual.
As the Senator will be aware, the Oireachtas put in place a robust legal framework in the 2013 Health Act which gives full statutory powers to the HSE to assess and make decisions on the reimbursement of medicines. An allocation of €30 million in budget 2022 has enabled the HSE to approve 24 new medicines to date this year. That is very good news. The Senator will appreciate that given the ongoing assessment process with respect to Kaftrio, the HSE is not in a position to comment further on this application. I will convey to the Minister his view that speed is of the utmost importance to these children and his request, on behalf of Cystic Fibrosis Ireland, for a meeting with the Minister.
I welcome the Minister of State at the Department of Agriculture, Food and the Marine, Deputy Martin Heydon.
I seek the Government's position ahead of next week's European Council meeting. I would like to hear very clearly from the Minister of State, who is here on behalf of the Minister, Deputy McConalogue, what the Government proposes to do to regulate exotic pets. Ireland has a completely lax system when it comes to exotic animals. I often raise concerns about the treatment of dogs and horses. At least in the case of dogs, we have microchipping and licensing laws, albeit that they are poorly enforced. There are no such regulations governing exotic animals. Only a few weeks ago, we heard from the exotic animal sanctuary that it is inundated with calls from people seeking to rehome their pandemic parrots. We also see news reports of reptiles being found abandoned or living in watercourses.
There is literally nothing stopping people from buying exotic animals. These animals have complex needs and in many cases are exceptionally long lived. They live for far longer than cats and dogs. The Federation of Veterinarians of Europe, which has daily interactions with exotic species, has said it is clear many species are not suitable as companion animals. They can experience extreme stress, boredom and depression and have severe behavioural issues, including self-mutilation. Irresponsible breeding, which is happening, has seen animals taken from the wild to feed the captive breeding industry. While Ireland is a signatory to the Convention on International Trade in Endangered Species of Wild Fauna and Flora, the evidence is there to show the exotic pet industry is having an impact on wild animal populations. The trade is also having an impact on our biodiversity here as some species become invasive.
Ireland needs to get a handle on the exotic pet industry. We need to look at what other countries are doing, see how effective their regulations are and introduce what is most effective. In the North there is a licensing system and Britain has introduced a certification process to ensure potential owners have completed a course to show they know how to look after the exotic species. I particularly want to focus today on the Cypriot proposal, which has a lot of merit. I want to hear the Department's view on it. Cyprus proposes to introduce an EU-wide positive list system for companion animals. Belgium introduced such a list in 2001 and it has clearly been very effective there. Proponents of the positive list argue it provides clarity. It is simpler and better than a negative list as it avoids the situation whereby if an animal is not listed it is permitted by default. Positive lists are a precautionary approach and are more effective against new unforeseen trends we might have in various exotic animals.
Will the Minister of State outline what Ireland's position will be at the AGRIFISH Council meeting on 24 May? If the Minister will not support the Cypriot proposal, which is backed by Lithuania, Malta and Luxembourg, what will he propose instead to address the issue in Ireland? We cannot continue with business as usual when it comes to exotic species in this country.
I thank Senator Boylan for raising the matter. At the upcoming European AGRIFISH Council meeting, the Cyprus delegation will share information with Ministers regarding the establishment of a new legislative framework for an EU positive list for the keeping of companion animals, as the Senator has outlined. Officials in the Department are awaiting the detailed wording of proposal of the Cypriot Government, and the Minister, Deputy McConalogue, will consider this carefully in advance of the meeting on 24 May.
Separately, and reflecting societal concerns about the keeping, breeding and trading of exotic animal species, officials in the Department of Agriculture, Food and the Marine have been asked to take the lead in establishing an independently chaired interdepartmental group to ensure a coherent national approach to policy and regulation related to exotic animals. This reflects the fact that such matters involve a number of Departments. The Senator has outlined her concerns, which I understand, about exotic animals. The situation is evolving. Exotic animals can have an impact in areas other than agriculture. It is important that all stakeholders and Departments are engaged in the process This is what we are doing with the interdepartmental group. This in line with the programme for Government and Ireland's Animal Welfare Strategy 2021-2025 - Working Together for Animal Welfare. Initial meetings of the group have taken place and its work will focus on regulating the keeping, breeding and trading of exotic animals. All aspects of these areas and models for best practice will be considered by the group in developing new regulations.
We are awaiting the detailed wording of the Cypriot proposal. We will give it due consideration and the Minister will work on it prior to the meeting on 24 May to see the implications of moving to a positive list as opposed to a negative list. With any regulation, we want to check there are no unintended consequences with regard to how it would affect other species. All of these issues will need to be considered when we have the detailed wording of the proposal from the Cypriots.
I thank the Minister of State for his response. I wonder whether it is the proposal I have in my hand, which is the Cypriot proposal, that he is awaiting. It is available. If he is worried about unintended consequences, they would come with a negative list because a negative list has to be exhaustive. A positive list clearly sets out what is permitted to be kept.
We know venomous snakes are being bred in Ireland. There are public health impacts related to exotic species. I am aware a sable in the country was found to be carrying a rabies-type virus. While I appreciate the programme for Government includes looking at animal welfare legislation, I encourage the Minister to listen very carefully to what the Cypriots will propose and give it due consideration. Even if he cannot bring himself to support the proposal, I ask for interim measures to be introduced. We are seeing significant animal welfare issues with exotic species. People do not know how to look after these animals. People have animals that can live for up to 80 years but they will not be around to look after them. I encourage the Minister to introduce at the bare minimum interim regulations to deal with this.
The Department has a proud history in supporting the welfare of animals, whether through policy initiatives, the provision of advice and guidance, financial assistance to farmers to help them improve their facilities, and financial support to animal welfare charities. Last year we launched Ireland's first overarching animal welfare strategy, reflecting the Government's clear commitment to animal welfare. The strategy is backed by resources and expertise in the Department and involves dialogue and co-operation with other Departments, agencies, stakeholders and civil society. We have strong protections for animal welfare in Ireland. The Animal Health and Welfare Act 2013 provides a regulatory framework for welfare. This framework seeks to ensure animals are kept in such a way that their welfare is provided for.
We are also fully engaged in the Convention on International Trade in Endangered Species of Wild Fauna and Flora, which covers endangered exotic animals, as the Senator outlined, more than 4,000 species of animals, and 25,000 plant species. Its aim is to ensure international trade in specimens of wild animals and plants does not threaten their survival in the wild and is sustainable, legal and traceable. The competent authority in Ireland with responsibility for CITES is the National Parks and Wildlife Service. It acts as the management authority that controls, permits and certifies species covered by the convention. The Department regulates the health status of animals entering Ireland. As I have outlined already, the Department is leading an interdepartmental group on exotic animals to advise on policy and regulation. I will ask that the Senator is made aware of developments arising from its work following the meeting of the AGRIFISH Council next week.
Further and Higher Education
One of the big successes in Irish society has been the rapid expansion of higher education in recent decades. It has gone from where we had one in five of those aged between 18 and 28 in 1980 going on to higher education to now having more than three in five, with many others going into apprenticeships and further education and training. It has become much more accessible. Even in financially difficult times during the 2010s we saw the number of places expand from 200,000 to 245,000. In response to the challenges facing students because of Covid, the Government rightly expanded the number of places in higher education. The difficulty, as the Minister of State knows, has been that while we continued to expand the number of places, the commensurate amount of money has not been made available to fund these places.
I welcome the fact the Minister, Deputy Harris, has announced a specific fund of €307 million will be available in the very near future to address some of the core funding issues. However, I am concerned.
The Minister has announced that there could be an additional 1,000 places provided in higher education this autumn, yet there is not complete clarity that those places will be properly funded. I welcome the expansion of places in higher education. It is important that we expand the number of places in apprenticeships and in further education and training, in particular in areas where we have skills shortages.
The indications are that the 1,000 places will be in the areas of medicine, healthcare, engineering and climate change. This is particularly welcome for those on medical and healthcare-related courses where, as we know, just over 40% of college courses that required 550 points or more last year used random selection in the allocation of those places. It is a very cruel blow to any student who has achieved those high levels to be excluded from a place. Expanding the number of places is welcome.
However the difficulty is that we have to have a very clear commitment that those places will be funded. If, for instance, as the Minister has said, expanding the number of places on medical courses will involve an additional 120 places being created over the next two years, that is something that is very welcome. Given that the full economic cost to the State of educating a student in medicine over a six-year period is in the order of €100,000 or even more, those 120 places will be an additional cost to the Exchequer of in excess of €12 million. If we are going to continue to expand our higher education system for every single additional place in terms of current expenditure, we need clarity that there are guarantees that the full economic cost will be covered.
In addition to that, there are also major challenges around capital costs. We cannot continue to squeeze more and more students into higher and further education places unless there is significant investment. If we talk to those involved in higher education institutions, they will all talk about the capital challenges they face. The expansion of higher and further education is incredibly welcome, but we have to ensure the model we use is sustainable and we need to give a guarantee, as a Government, that any new places that are created this year will be properly funded.
I thank Senator Byrne for raising what is an important issue. I am taking this Commencement matter on behalf of the Minister, Deputy Harris. We are very aware of the demand that exists for places in higher education. Demographic factors mean demand will only increase in the coming years and we must work to ensure there is a place in third level education for everyone who wants one.
Our higher education system has already expanded considerably over the past number of years. As the Senator outlined, full-time graduate enrolments rose by 9% between 2014 and 2020 and are expected to increase by another 15% by the end of the decade. A significant number of additional places were created in 2020 and 2021 in response to the disruption of Covid-19, as the Senator said. This year, officials are working with the HEA and the higher education sector to create additional places in key skills areas, as identified by our skills architecture. This work is at an advanced stage and it is hoped a significant number of additional places can be created. These places will help to address skills need in areas such as healthcare, construction and green skills.
When we are increasing capacity in any area of education, it is vital that we do so in a sustainable way and maintain the high quality for which our education system is known. That is at the heart of the points raised by the Senator. We talked about securing funding for this and being able to provide for places into the future, based not on demographics but on the increased demand we need to meet.
Earlier this month, the Minister, Deputy Harris, published Funding the Future, the Department's ambitious policy document that seeks to address funding issues in the higher education sector, improve the quality of programmes and learning outcomes and reduce the cost of education to students and their families. The Senator referenced the €307 million in funding. That planned additional investment will be made over a number of years to address the core funding challenges. This does not account for future demographic needs or new policy proposals for higher education.
The Minister, Deputy Harris, will shortly convene a high-level higher education reform implementation review group to drive reform in this area. It is also important that we examine how we increase capacity, not only in the higher education sector but also in further education, training and apprenticeships for those most suited to those areas. I can talk a little more about the apprenticeship side in my supplementary reply.
I take on board the points raised by the Senator. They are very valid. We want to create additional places. We have to make sure they are funded sustainably all of the way through the system. The points he outlined, such as the example of medical students, are valid. The Minister, Deputy Harris, is working to ensure that the places that are delivered are sustainably funded and that we have as many as we need and can provide. That is the approach and determination across the Government.
I thank the Minister of State for his response. I appreciate that it is not his portfolio, but the commitment is welcome. It is notable that, as he said, the €307 million the Minister has referred to is about addressing current challenges around core funding, rather than dealing with future challenges. That is why it is essential that if the additional places in further and higher education are created, we have to make sure every single one is funded sustainably. We cannot continue to say that we have solved the problems of the past with a sticking plaster and then create more problems.
As the Minister of State knows, the problems are not just demographic. Some reports have suggested that because of the convergence of new technologies, within the next decade 65% of current jobs will either be redundant or significantly change and, as a result, we will all need to upskill and reskill. There is a major role for our further and higher education systems to address that. We have to be radical. The model we use has to be sustainable. I would like the Minister of State to take the message back to the Minister that if he is creating 1,000 additional higher education places, as well as places in further education, that is all very welcome, but they must be funded into the long term.
I thank the Senator for his follow-up response. We are committed to supporting a balanced further and higher education system which has a multitude of pathways for learners to follow. The action plan for apprenticeships sets out new ways of structuring funding and promoting apprenticeship, with a target of 10,000 apprenticeship registrations per year by 2025. In 2021, a record 8,607 new apprentices were registered, an almost 40% increase on the figures in 2019, the last normal pre-pandemic year.
We are working to strengthen the further education and training system under the strategy for the sector. It is important that capacity in the higher education sector is not increased in a way that undermines this work. That gets to the heart of the Senator's point about sustainability, namely that whatever increase in places we have is sustainably funded. People do not just enter into first year; they are there for the long haul. The Senator mentioned medicine, which can involve six or seven years of education.
If a significant number of places are provided in the further and higher education system in ways that are not sufficiently targeted, learners may end up migrating away from further education offerings that represent better learning options for them and provide superior career opportunities. This has the potential to impact on retention and success rates. We will continue to work to ensure our education system expands in a sustainable and balanced way that ensures a pathway in education is available to all who want and need it. That is at the heart of what the Senator has spoken about today and what we and the Minister, Deputy Harris, need to do to get this right. In terms of the additional places for which there is demand, we want there to be an array of different education options that are adequately funded so that people can see a pathway through when they choose one.