Léim ar aghaidh chuig an bpríomhábhar
Gnáthamharc

Dáil Éireann díospóireacht -
Tuesday, 26 Sep 2017

Vol. 959 No. 3

Leaders' Questions

In recent years, nothing has been more heart-rending than the shocking waiting times for children and young people for surgery for scoliosis. Children's health has been compromised by the undue delays and in many cases, optimal outcomes have not been achieved as a result of the delays. Getting the surgery on time is critical not only to full recovery but to the proper, full development of a child's potential. On 1 September on the "Late Late Show" there were very revealing stories told, particularly by Megan Halvey Ryan who waited 18 months for an operation. As a result of the long delay, she had to have full spinal surgery and has less flexibility because of the nature of the operation she had to have as a result of the long delay. The Taoiseach's predecessor, Deputy Enda Kenny, said it would be an absolute priority that those on the waiting list would not have to wait longer than four months and that would be the case by the end of 2017. However, that was in March and the situation as of last month is that those waiting list targets have been missed. The number of children waiting for more than four months has increased from 124 to 145 and for some of those it is much longer than four months. I am dealing with a case of a young boy aged 15 years who has been diagnosed as needing urgent surgery. In August 2016, he was put on the surgical waiting list. The surgeon is saying it is urgent. He has complications caused by other conditions such as spina bifida. He is in a wheelchair. I have spoken to his mother, who emailed me this morning saying that humanity, empathy and compassion need to be taken into account when dealing with her son's case. She is at her wit's end. She is totally stressed as a result of the lack of progress on the waiting time. There is also the fear that if it does not happen on time, his health will be further compromised. In his case and others, what has been going on for the past three to four years has been quite shocking and represents a failure in providing resources. Will the Taoiseach indicate that the waiting list target - the absolute priority set by his predecessor - will be met by the end of this year and that urgency will continue to be attached to cases such as that of the young man I referenced and about whom I have communicated with the Minister and others?

It is quite shocking to have to go back to the mother of such a child. The mother is relatively helpless in progressing the case further. Can the Taoiseach give a firm commitment that waiting targets will be achieved?

I thank the Deputy for raising this very important issue, which is very close to my heart. I took an interest in it, both as a doctor and as Minister for Health. We can all accept that far too many people in Ireland are waiting far too long for treatment. People are well aware that about 600,000 people are on one form of waiting list or another. More than half of those people will be seen in less than six months and about a third of people are seen in less than three months. However, many people are still waiting more than three months and more than six months, which is not something we want to continue or to stand over.

The waiting lists for surgery for inpatient and day-case treatment are starting to fall. The most recent figures from August show a fall of 2,000 in the number of people waiting for surgery - waiting for procedures or operations. That is due in part to additional investment in the health service with a record budget this year and additional funds provided to the National Treatment Purchase Fund.

Dealing with scoliosis in particular, as the Deputy knows, the Government has a scoliosis action plan in place. When I was Minister for Health I met the surgeons who perform these operations and met representatives of some of the interest groups. One of their big requests was that a new theatre be provided in Crumlin hospital. That cost about €2 million or €3 million. That new theatre is now in place and open. Quite a number of cases are now being outsourced to other hospitals including, for example, to Blackrock and Stanmore in London. The number of operations has increased. It is a good sign that more people are being treated and having their surgery, but people are still waiting a very long time.

The four-month target was set by the director general of the Health Service Executive, which is funded to meet that target. I will certainly be calling on the HSE to deliver on that target. I discussed it with the Minister for Health in the past couple of days and it is intended to have a treatment plan and a treatment offer for every child who is waiting for scoliosis surgery. It may not be possible to perform all operations in Crumlin by the surgeon of choice, but certainly people will be given the offer of treatment abroad if they are waiting more than four to six months on the surgical waiting list for that. Of course we understand that some parents will - for totally legitimate reasons - prefer to have the treatment in their own country rather than going abroad, but the treatment abroad option will be there.

If the Taoiseach is honest, he will admit the only reason progress was made was because the Government was shamed into it by television programmes and ones on RTE in particular, which highlighted earlier this year the long waiting times for young people with scoliosis in particular. It took that kind of media profile to get action from the Government because in 2014, 2015 and 2016 the resources were not provided and the scoliosis waiting lists were allowed to grow far too long. Parents will say that whoever gets on the media gets a better chance of getting an operation which is obviously not the route to take. The Government had to be dragged kicking and screaming to adopt the National Treatment Purchase Fund as a strategy to reduce waiting times. It is belated and has been too slow in implementation.

On the scoliosis question, it is the Minister for Health who is responsible to ensure this happens. The Taoiseach cannot keep passing the buck and trying to detach himself and the Government from the reality on the ground as it affects young children's health and, crucially, their outcomes. We want an optimal outcome for these children. Because of the complications that apply in certain cases, not every child will be in a position to go overseas for an operation. It is vital that every action is taken. We need ministerial and Government oversight to ensure what the Ombudsman for Children has declared to be a contravention of children's rights is rectified and that children in this case get their operations on time to ensure they get an optimal outcome as a result of the treatment of their condition.

It is not an issue of shame. All of us in Ireland and in this society should be ashamed that children have to wait such a prolonged period for operations.

Sadly, this is a problem that has existed for as long as I can remember. When I was a medical student, there were long waits for scoliosis surgery. I believe Deputy Micheál Martin was the Minister for Health and Children at that particular time. The waiting lists might not have been as long as they are now but they certainly were very long.

The Taoiseach is blaming everybody but himself.

This is an issue that has been a problem for us certainly as long as I can remember. The question I want to answer and the one I think is the most important to be answered is what are we doing about it. The new theatre in Crumlin is now open. The additional nurses are now in post in Crumlin and Temple Street and an additional orthopaedic surgeon will commence work in Crumlin in early October. A total of 226 surgeries have taken place in Crumlin and Temple Street so far this year, which is a significant increase already on last year. A total of 23 cases have been outsourced to the Mater, Cappagh and Stanmore and the HSE has also completed an international tender for paediatric spinal fusion procedures to take place in three other hospitals. Those hospitals will commence patient reviews immediately with a view to commencing treatment in October 2017.

It is fair to say that we are pulling out all the stops and doing everything we can to make sure more children have the surgery they need within an acceptable time period, and if that involves offering people treatment abroad, we will fund that but we understand and accept that for perfectly legitimate reasons every parent may not wish to accept the offer of treatment abroad.

The forthcoming budget represents a genuine opportunity to deliver for those who are struggling to make ends meet. The Taoiseach says he represents those who get up early in the morning. I can tell him that nobody gets up earlier in the morning than those who are raising young children. While Fine Gael and their friends in Fianna Fáil engage in a sham fight over tax cuts, and hammer out a budget that will disproportionately benefit the well-off in society, young families in Ireland are faced with some of the highest child care costs in the world. In his so-called republic of opportunity, many parents are paying what amounts to a second mortgage to ensure that their children are looked after. The reason for that rests squarely at the feet of successive Fine Gael and Fianna Fáil-led Governments which completely failed to invest in the early years sector.

Announcing measly tax cuts that will put loose change in the pockets of those families is no good. They will not be so easily bought off. By signalling a preference for tax cuts over the necessity to build decent public services, the Government is choosing to abandon those families. We in Sinn Féin have also made a choice. We have chosen to stand on the side of the struggling families. We want to see a budget that puts their interests first through the proper funding and resourcing of the early years sector. High quality affordable child care is an essential public service. It allows parents return to work and avoid poverty traps and it provides employment.

The Taoiseach needs to wake up to the pressures young families are facing today. They are hanging on by their finger nails. He must commit to providing high quality, affordable child care throughout the State. In our alternative budget, Sinn Féin proposes an increase in the universal child care subsidy – from 50 cent an hour to €2.50 an hour. That is a fivefold increase. This measure would put €420 a month, per child, into the pockets of struggling families. It would make a real difference not only for parents, but also for child care providers who are prevented from reinvesting in their services as they operate on a break-even basis. My question to the Taoiseach is very simple. Will he adopt this proposal in budget 2018 and give those families a real break?

First, I would like to restate the budget priorities that I have stated now on a number of occasions but I will do it again in the House so that everyone can hear it. My first priority in this budget is to balance the books, and to do so for the first time in ten years. What that means, roughly speaking, is for the first time in ten years the amount that we take in in terms of revenue will match what goes out in spending. That is the prudent thing to do. I am pleased to hear that the party opposite, Fianna Fáil, support that. I would like to hear from Sinn Féin as to whether it will also support our policy of balancing the books and doing so for the first time because that is the prudent thing to do and that is the thing that matters most for children because they are the ones who bear the consequences in the future of bad economic policy and they are the ones who would bear the consequence of us continuing to increase our debt.

We are not going to do that. We are going to balance the books and reduce the debt. That is the right thing to do for families and particularly for children. They are the ones who bear the long-term consequences of bad economic policies.

Our second priority is additional funding for public services and infrastructure. We anticipate spending increases of between €1.5 billion and €2 billion next year. Most of that is down to demographics. Most of it is commitments already made. There will not be huge scope for additional announcements on budget day but there will still be a significant increase in public spending next year, to improve public services and infrastructure. After that, we will find some space to improve the take-home pay and living standards of people in Ireland who go to work, namely, the 1.4 million taxpayers. I think they deserve something because it is the work they do and the taxes they pay that allow everything else to be possible.

In terms of what we have done for families - I am not just talking about Fine Gael here - successive Governments of Fine Gael, Fianna Fáil, the Labour Party and Independents have brought child benefit to one of the highest rates in Europe. We brought in a free pre-school year and then brought in a second one. We increased the back-to-school clothing and footwear allowance by 25% in the most recent summer period. For the first time, we brought in subsidies for child care, which took effect in September. The Minister, Deputy Katherine Zappone, who is in the Chamber, led the initiative on that. We also brought in GP care without any charge for children aged under six. We are going to build on that as well. That is just by way of example of the kind of things that every other party in this House has done for young families. What has Sinn Féin ever done for young families?

I have raised one.

The Deputy should tell me what her party has ever actually done for young families. I see around me Deputies from Fianna Fáil, Fine Gael, the Labour Party, Independents, and the Green Party who can all say that they did something practical and useful for young people. When Deputy McDonald says she has made a choice and that she stands with young families, that is totally bogus. Sinn Féin made a choice to opt out of Government. It does not want to be in government here. Its MPs do not want to take their seats at Westminster. It does not want to be in government in Northern Ireland, or at least it appears that way. In local authorities, its councillors take decisions all the time that are not in the interests of the public but are just populist. In fact, Sinn Féin is the only party in this House that has never done anything for children.

For the record of the Dáil, I am actually raising two young children. While I regard that as something of a personal endeavour, it also puts me, like so many others, in a position to understand that all of the cant and empty rhetoric about balancing the books is not worth a fig to struggling families. To couples at work or individuals on their own who have to provide care for their children, lofty words about balancing the books from An Taoiseach in that dismissive way are of no use. Children are all too familiar with the hardship of the messed up economic policies that the Taoiseach and his friends have pursued. Hundreds of them are now in emergency accommodation courtesy of those economic endeavours.

I asked the Taoiseach a question and expect a response to it. I have said that we need to increase funding and that we need to do so in such a way as to put an additional €420 a month into the pockets of struggling families. It should be done through the universal child care subsidy. The resources are there. We have the fiscal space. In a full year, our proposal would cost the Exchequer €116 million. I cannot imagine a better spend of that sum.

With all due respect to the Taoiseach, he should answer the questions. He should not dream of attacking us on the basis of our care or otherwise for children. Given the record of his Government and successive Governments, he has considerable neck to advance that position.

(Interruptions).

The only answer I can give to the Deputy with regard to any budgetary decision between now and budget day is that announcements will be made on budget day.

It will be somebody else's problem then.

That will be the answer I will give her to any question she may wish to ask between now and budget day. We will use the budget to put money back in the pockets of families.

They will put €5 on the pension.

There are many ways that can be done. It can be done through tax reductions, welfare increases, pay restoration or a combination of these things. It can also be done through services. The Deputy can be guaranteed that, just as was the case last year and the year before, we will use this budget as an opportunity to put money back in the pockets of the families of this country. However, we will do so in a sustainable way. There is no point in giving something to families now only to take it away in a few years' time.

I have to say I am a keen observer of politics. More and more, Deputy McDonald reminds me of-----

The Taoiseach is an observer all right.

I thought the Taoiseach was a practitioner of politics.

I am a practitioner and an observer.

I thought he was on the pitch.

Simon and others have been saying for the past couple of years that the Taoiseach is just an observer.

Even though their politics are totally different, Deputy McDonald reminds me more and more of Marine Le Pen because she always goes back to her script. She delivers a scripted question and when I give her an answer and ask her a question, she goes straight back to the script again.

The Taoiseach should not be elevating her.

I do not think that is the kind of leadership we need in this country.

There is a compliment buried in there somewhere.

I do not know how much the Taoiseach knows about how housing is supplied in this country or about how the construction industry here works.

Not as much as the Deputy.

I do not hold the Taoiseach personally responsible for the fact that the Government has failed to deal with the housing crisis for six years, but he is the boss now and it is on his plate. If the Taoiseach is interested in doing this country a massive favour by deciding to tackle something that no one before him has tackled, he should start by no longer listening to those who have a vested financial interest, including the likes of the Construction Industry Federation, the people who control the real estate investment trusts and the developers. Many developers do not even build any more; they are just working the money. The development land market is controlled by investors rather than builders. Combined Government measures have encouraged investors to purchase and hold large tracts of serviced residential land. In 2012, the Government introduced incentives to get private investors to buy assets at firesale prices and hold them for seven years. It was an incentive not to build. In last year's Finance Act, the period in question was reduced to five years in the case of certain funds. The vacant site levy is a joke. There are more holes in it than in a sieve.

There is a multitude of problems with how we supply housing. The failure to deal with those problems means the next bust is never far away. Will the Taoiseach consider tackling landbanking, which is at the heart of many of our housing supply problems, in a real and meaningful way in next month's budget? The private sector does what it does. It maximises its earning potential in any way possible. The private sector builds when it likes and where it likes, as is its right. The State should not depend on the private sector to provide social and affordable housing. We have tried that approach and it has not worked.

The Taoiseach has spoken about repurposing NAMA to solve our housing problems. NAMA is under investigation in Britain, the US and Ireland. Just 6% of the land that NAMA has sold has been built on. Just 3,000 out of a potential 50,000 homes have been built on that land. Why did NAMA sell land to people who had a vested interest in sitting on it? Why did it sell it at fire-sale prices? Approximately 8,000 units are being developed in Cherrywood. NAMA sold the sites for some 3,800 of them to Hines for approximately €27,000 apiece. Each of those sites is now worth over €100,000. How clever was that? In March 2016, the Irish Strategic Investment Fund invested €30 million in Ardstone Homes. One month later, NAMA sold 120 acres to this developer for €50 million. In addition to selling large bundles of land on the cheap, the State is putting up the money for private developers. Although NAMA has neither the expertise nor the personnel with a background in housing to solve this housing crisis, which it helped to create, it still has close to 5,000 acres of land. None of the NAMA board has any experience in property, not to mention residential property. I put it to the Taoiseach that it is time to give this land to the local authorities to provide social and affordable housing at a reasonable price.

When it comes to this policy matter, and almost any policy matter, the role of the Government is to listen to everyone. Of course we will listen to entities that can provide finance. Of course we will listen to builders who have experience in building homes. As politicians, our constituents are the people to whom we listen the most. Everyone on this side of the House is aware that a large number of those who come into our constituency clinics are struggling to hold onto their homes. Large numbers of people in their 20s and 30s who aspire to own homes for the first time are struggling to do so. I assure the Deputy they are the people to whom we, as practising politicians, listen most often and most frequently.

In terms of next year, because of the increases we are seeing in housing activity, in planning permissions coming through, commencements and so on, we expect approximately 20,000 new homes to be built in 2018 - a significant increase on this year - of which 15,000 will be provided by the private sector and in the region of 5,000 by the Government. It is not the case that we will rely on the private sector to build. We will ramp up the provision of council houses and apartments to approximately 5,000 next year, with 3,800 to be built directly by local authorities and 1,200 to be acquired - in some cases through bringing long-term voids back into use and through Part V provision in others.

In terms of land hoarding and vacant sites not being developed, we have introduced a vacant site levy. The first step will be to draw up a register of sites that are vacant, establish that they are vacant and then impose the levy in respect of them. That is a policy that exists already. We will impose a vacant site levy of 3% on undeveloped sites. It certainly is not working yet. The advice we have is that we need to give people notice to develop. We cannot just impose the levy immediately; people have to be given an opportunity to develop sites. However, that will start to kick in and we will begin to see some of those sites coming into use.

If the Taoiseach examines the vacant site levy, he will see that the penalties for not building are so minuscule that it will pay the people to continue to sit on land and watch the price increase. Every time the price of a house goes up by 10%, the price of the land goes up by a minimum of 30%. In the past three years, 26 houses have been built in Wexford; that is seven per year. It is not happening. The Government has brought out so many measures at this stage we have lost count of them.

In 2016, NAMA sold Project Abbey, the loan portfolio of developer Harcourt Developments, for €300 million. Before it did so, NAMA took out 72 acres of the land and boasted at the housing committee that it would be used for housing. That sounded great, but last week we discovered that it has just turned around and done a deal with the very same developer to build X number of houses. That developer is getting his land back and he will make a fortune on it. The houses in question will not be available at an affordable price for people.

From 2010 to 2016, the average cost of new homes in Dublin increased by 62%, that is, from €284,000 to €461,000. In November last year, the then Minister, Deputy Coveney, confirmed the cost of a three-bedroom house from the local authority was €205,000 in Dublin and €154,000 outside Dublin. Where in God's name is the logic of engaging the private sector to supply housing in the private market for people who cannot afford it? The State can do so. It has got to use the local authorities much more than it is proposing to do at present. It is possible to provide social and affordable housing to people who need it.

It is absolutely our intention to use local authorities more into the future than we have done in the past. As the Minister, Deputy Eoghan Murphy, has just informed me, the number of houses built by local authorities this year will be 2,400. That is four times as many as they built two years ago. I appreciate that is coming from a very low base but to increase the number of local authority houses being built fourfold in two years is significant. We will increase it again next year by another 50% - to approximately 3,800 - so we will ramp up the amount of housing built by local authorities. Yesterday, the Deputy will have seen on the news that not too far from here, near the Grand Canal in Charlemont Place, the Minister, Deputy Eoghan Murphy, doing exactly what he said he should do, namely, topping out a new mixed-use development that has commercial-----

And the developer did not build it-----

-----private and social housing elements to it. The Deputy will see a lot more of that in the period ahead.

To give Deputy Wallace some other information, 15,000 new houses were completed in 2016, which was an increase of 18% on the previous year.

That is ESB connections.

Furthermore, there has been a 40% increase in both planning applications and commencement notices-----

The Taoiseach believes everything he reads.

-----year on year. Not that long ago, people were saying that no student accommodation, new hotels or commercial property was being built. We are now seeing hotels, student accommodation and commercial property being built all over the place.

Can the people afford to rent student accommodation? They cannot. The rents for students are prohibitive.

Next up - it is starting already - is a significant increase in the building of homes, which I believe we will see happen over the next few months and into next year.

A Deputy

That is starting now, is it?

We learned from media reports this morning that the Taoiseach and his Government are considering holding eight different referenda within the next two years. These range from important matters such as repealing the eighth amendment to changing the law on blasphemy to matters such as-----

Getting up early in the morning.

-----lowering the voting age to 16. There is one glaringly obvious omission from that list, namely, a desperately-needed commitment to amend the Constitution in respect of Article 43. Article 43, as the Taoiseach knows, acknowledges a natural right to private property above any human-made law. It goes on to state that this right must be regulated by the principles of social justice and that, on occasion, such rights need to be delimited by the exigencies of the common good. Notwithstanding these safeguards, regrettably, the superior courts have consistently taken the narrowest view of Article 43 when the exercise of property rights is deemed to be detrimental to the common good. In the main, the courts have found in favour of the upholding of private property rights or else have ruled that the State must pay prohibitive levels of compensation. The impact of Article 43 has been most profound and most detrimental in respect of the provision of housing. Successive Ministers with responsibility for housing have claimed that Article 43 significantly restricts the capacity of government to introduce key measures to deal with the housing crisis. I refer, for example, to the imposition of a meaningful vacant site levy to address the pressing issue of land-hoarding and not just the meagre little levy that is promised to kick in at some point and which is far lower than the inflation rate of vacant land; measures to tackle the large number of vacant properties; measures to prevent the eviction of families in cases in which a landlord is selling a property; and attempts to implement compulsory purchase orders in respect of unused housing landbanks. While there are major problems regarding housing and housing land, leading to a crisis of affordability and supply, it seems there is no appetite on the part of the Government to remove the constitutional obstacle that is Article 43. How on earth is the amending of Article 43 of the Constitution not on the Taoiseach's priority list for a referendum? Without amending Article 43, how can we achieve social justice and serve the common good in respect of housing? Will the Taoiseach now commit to an early referendum on Article 43 in order that the housing crisis can be tackled comprehensively and effectively and we get no more excuses from Ministers?

The priority list agreed by Government today creates indicative timelines for future referendums. The referendums very much flow from the Citizens' Assembly. The Citizens' Assembly did make a recommendation regarding economic, social and cultural rights, and I understand that this, as well as a proposal on housing, has been referred for further consideration to the Department of Finance. The proposal - at least, the indicative proposal - is to have a stand-alone referendum on the eighth amendment in May or June next year. That will very much follow on from the recommendations of the all-party committee that is considering the matter and which has a deadline to report by Christmas. Further referendums are to be held concurrent with the presidential election, whether or not the position is contested, in winter of 2018, dealing with women in the home, blasphemy and the possibility of plebiscites on directly elected mayors. Then, in summer 2019, concurrent with the local and European elections, referendums are to be held to extend the franchise to citizens abroad to vote in presidential elections and to liberalise the divorce laws on foot of Deputy Madigan's Bill.

I dislike the term "property rights". It implies that properties have rights. Properties do not have rights; individuals have rights. If one owns a farm, one has a certain right to deal with that farm, manage it and do what one likes with it. If one has a business, one has certain rights over that business.

If one has a home, one has a right to live in it. Of course, if one has an investment property and it is one's pension, one has certain rights to it too. When we talk about diluting or removing property rights, we should not make the mistake of thinking we are removing rights from properties; we are removing rights from people. I would like to understand better from those who advocate diluting those rights exactly which individual rights they want to take away from which individual people - specifically what and why.

Nonetheless, the protection of property rights in the Constitution can actually be over-egged. We have a vacant site levy. We brought that in notwithstanding property rights, and it is now in place. We have brought in the rent pressure zones, putting caps on rent increases. Again, some people said that was a violation of property rights but it turned out it was not. It is also the case that local authorities can use CPOs to CPO vacant properties and, in fact, Louth County Council has done that on dozens of occasions. People often hold up property rights as an excuse for things not being done but we have shown, on a number of occasions, that we can do those things without breaching property rights.

It seems the Taoiseach is only interested in the rights of people who have property, not the rights of other people who are on the housing waiting lists, who are homeless and so on. One would have to ask how many homeless does it take for the Taoiseach to recognise the obstacle that is Article 43, and it is most profound, obviously, in regard to housing. The Taoiseach clearly is not listening to the points that are made very strongly by the current Minister for Housing, Planning and Local Government and previous Ministers for housing in respect of the obstacle Article 43 has put in their way. In addition to the whole area of housing, Article 43 has been a long-standing impediment to fair and balanced legislation in many different areas. For example, we know that, in 1996, the Supreme Court ruled that the Employment Equality Bill was unconstitutional because it put too much of a cost burden on employers. We know that the risk of unconstitutionality was also cited as the reason that the last Government reneged on its promise to abolish upward-only rent reviews. We know that, in this Government, the Minister, Deputy Naughten, has indicated that Article 43 is an impediment to legislating to address the over-concentration of media ownership in this country. For all of these reasons, but particularly in regard to the housing crisis, I ask the Taoiseach to reconsider his priorities and commit to a referendum to amend Article 43 of the Constitution.

I think there is a difference between not listening and not agreeing. I am listening, although that is not necessarily the same thing as agreeing. As I have already said, we have, on a number of occasions, considered the balance of property rights and the public interest. Property rights in Ireland are not exclusive; they are not without limitation and are limited by the public interest. We have used that public interest test to bring in rent caps, which have kept rents down in large parts of the country. CPOs are used regularly to CPO land for everything from housing to roads, and we have also brought in the vacant sites levy. Certainly, if the Deputy has a specific proposed wording that she wants introduced into the Constitution, as this Government does not have a majority in the Dáil, it is absolutely open to her to bring that proposal to the floor and to have a vote on it in this House.

Barr
Roinn