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Dáil Éireann díospóireacht -
Wednesday, 27 Sep 2017

Vol. 959 No. 4

Leaders' Questions

I want to raise with the Taoiseach the scandalous issue of the capacity of young teenagers to access child and adolescent mental health services and the enormous stress that their families have to endure because of what is an appalling situation - I am not exaggerating - across the country. Waiting lists to access services have jumped by 28% to 2,908 people. The number of people waiting for longer than one year has increased by 78%. There are 6,000 children waiting for primary care psychology appointments, 1,784 of whom have been waiting for longer than a year. These are the HSE's own data on the services in question. For some reason, the Cork-Kerry region is extraordinarily bad in terms of the numbers waiting longer than a year at 158 out of 324.

The capacity of the Department of Health, the Minister and the system to respond seems very poor. One in three posts has been filled in mental health services from 2015 to 2016. In that time, 520 approved positions were allocated, but it was nowhere near what was required. Some 2,000 extra staff were required, yet only 93 additional staff have been recruited in 2017. In child and adolescent services alone, people say that close to 600 staff are required before we can get those services to where they need to be.

I have a caseload of children and young teenagers that is quite shocking. In one case, there was a June 2016 assessment of need, a complaint was made that November and, eventually, a solicitor had to write a letter. In May 2017, the assessment was carried through. I have a list, as I am sure every Deputy does, of young children who have been unable to access mental health services.

The Roscommon report, published on 1 September, illustrates more dysfunctionality.

There is also the incredible situation of the loss of a significant number of nursing staff. The report estimated a shortage of 50 nurses in Roscommon and about 100 in Galway while money was being handed back. For two years, Deputy James Browne and I have been going to both the Taoiseach's predecessor and the former Minister of State with responsibility, Deputy McEntee. Who is in charge? Where is the Government oversight? Where is the ministerial oversight? There is an incredible inertia in our mental health services, an incredible lack of joined-up operations and of people working together as they should. Nobody is in charge. Ministers seem to be conduits receiving information and passing information on. No one is drilling down in terms of what is going on on the ground. Ministers for Health and Ministers of State with responsibility for mental health seem to be in that position to get promoted out of it. The lack of achievement over the past number of years in this area is truly shocking and unacceptable for the young children and teenagers and their families.

Everyone in the House understands the need to improve our mental health services, particularly for young people. Everyone in this House understands how important mental health is. One of the positive things that has happened in the past number of years and decade is a much greater willingness by people to talk about mental health, to treat it seriously as an issue and to improve services. The question the Deputy asks is quite a valid one. It is not simply a case of resources. If the Deputy looks at the budget for mental health in 2012, the year after his party left office, he will see it was €711 million. This year it will be €853 million. In a period when budgets were very tight, the mental health budget increased by €140 million. The question we need to ask ourselves is why we are not getting better value for that investment and why we are not seeing significant improvements in services. The HSE has statutory responsibility for mental health services. There is a national director of mental health and a director general above the national director. Political responsibility rests with the Minister of State, Deputy Jim Daly, who is relatively newly appointed. He reports to the Minister, Deputy Harris, who reports to me. It is important to acknowledge there are unacceptable delays in people receiving the appointments they need. It is also equally important to acknowledge some of the progress that has been made. As I mentioned, there has been an increase in funding of €140 million a year since the Deputy's party left office. We now have the national forensic mental health hospital under construction in Portrane, which will allow us to close a very old facility in Dundrum. There have been improvements to counselling services, including new Jigsaw sites - one in Cork, which the Deputy will be familiar with, two in Dublin and one in Limerick. We are also seeing the continued development of community health teams and the child and adolescent mental health services, CAMHS. Specifically on the issue the Deputy raised on psychology, approval has now been granted for additional staffing resources and this will include 114 additional assistant psychology posts. There has also been an increase in the intake of undergraduate nursing from 60 last year to 130 this year, which will more than double the number of undergraduate psychiatric nurses being recruited. It raises the fundamental question that we always run into when it comes to health, which is that more staff, resources and funding do not necessarily result in better services and outcomes. It is an area on which we will need to really focus in the years ahead.

We have been hearing this for the past four years. The Taoiseach's reply is somewhat similar to what Deputy Enda Kenny or the former Minister of State with responsibility, Deputy McEntee, would have given us. If the Taoiseach talked to the parents he would know they will not be satisfied with the idea we all have a better understanding of mental health services. Neither will they be satisfied with the passing of the buck and the sort of detached commentary that suggests it is somebody else's job to do this. It is the Government's job to drill down and make sure that things get done. The extraordinary waiting times that people have to experience must end. We have made suggestions to the Government on this such as utilising non-governmental organisations far more effectively than it has and to do things differently in respect of the private sector. We have met with resistance, inertia and have received no answers from either the former Minister or the Government on this crucial question.

Last Monday, I met a family with a six and a half year old child. They have been contacting the services since the child was three and a half years old and still cannot get an overall assessment of need. It is about time we stopped all the language and spin and got on top of this for the sake of the families concerned.

Go raibh maith agat.

These families are listening to language such as, "We're going to create a republic of opportunities."

Go raibh maith agat, a Theachta. Tá an t-am caite.

These children and young people have been denied opportunities and will continue to be denied them-----

-----until somebody assumes political responsibility and takes charge of this specific area-----

Go raibh maith agat.

-----of child and adolescent mental health-----

Tá an t-am caite.

-----and ensures that people can get timely access-----

Tá an t-am caite.

-----to the services that they so desperately require.

Caithfidh mé bheith féaráilte. Tá am an Teachta caite. Tá a fhios agam gur ceist phráinneach agus tábhachtach í seo. Tá bomaite amháin ag an Taoiseach.

The Deputy asked me a straight factual question and I gave him a straight factual answer. Statutory responsibility lies with the Health Service Executive. That is what the Health Act stipulates. The Health Act was passed by the Houses of the Oireachtas and it was brought into the Houses by the Deputy when he was Minister for Health and Children.

No, it was not actually.

That is where the statutory responsibility lies.

That is a silly point.

However, I fully accept-----

The Taoiseach should just deal with the issue.

-----that, of course, political responsibility lies with the Minister of State with responsibility for mental health, Deputy Jim Daly, who reports to the Minister, Deputy Harris, who reports to me. I fully accept political responsibility for dealing with these problems and I fully accept that there are problems that need to be dealt with.

The Deputy will be aware that today the CSO will produce provisional figures on suicide, indicating a decrease in the number of suicides by 11.5%. Of course, any death by suicide is one too many. Almost all of us in this House, including me, have been affected by the issue of suicide. Suicide is not just about the person who takes his or her life.

Go raibh maith agat.

It is also about the impact on their families and friends, and people who think about what might have been done and whether they could have done more. However-----

Go raibh maith agat, a Thaoisigh.

-----it is welcome to see that reduction.

Part of it is down to the work that was done in previous years, with a trebling of the funding for the National Office for Suicide Prevention and the suicide prevention strategy introduced by the former Minister of State, Kathleen Lynch, and I when we were in the Department of Health. We will continue to work on these issues and-----

I thank the Taoiseach.

-----continue to ensure we have better outcomes.

If the relevant committee decides to extend the time for this from three to four minutes or whatever, that is a matter for it. However, I have to abide by the Standing Orders that are in place. I call Deputy McDonald, who I know will adhere to the three minutes. I simply remind her.

The clock has started.

Yesterday, the Taoiseach told us that his primary aim in budget 2018 is to balance the books. He expressed this as a priority - indeed almost as a virtue - in response to my question about the need to provide real investment in order to slash the crippling cost of child care in the State. Meanwhile, at yesterday's meeting of the Joint Committee on Finance, Public Expenditure and Reform, and Taoiseach, representatives from AIB told my colleague, Deputy Pearse Doherty, that it will not pay any corporation tax for the next 20 years. A bank that is now profitable will pay no corporation tax - zip, zero, zilch. As the Taoiseach knows, AIB made a pre-tax profit of €814 million in the first six months of this year. The tax that is due on these profits is money that is badly needed to deal with the crises in our crumbling public services, not least those relating to health and mental health. However, we have a golden arrangement with the banks as a result of a legislative change introduced in 2014 under a previous Fine Gael-led Government with the assistance of the Labour Party and yet the Taoiseach talks about a tight fiscal space.

Is it any wonder that we have a tight fiscal space? After all the austerity, the cuts and the hardship that the Taoiseach's party visited on ordinary people, the banks are back in profit and are told that they are scot-free regarding their corporation tax obligations. This is happening at a time when families still struggle to keep the wolf from the door to pay their bills.

I find this a very strange way to go about balancing the books. I can only imagine what the 8,000 people deprived of a place to live will make of this or what the 494 patients who were on trolleys yesterday might make of this. This cosy tax-free deal for the banks really amounts to another bailout for them. Much like the Apple tax debacle, it emerges again that the Taoiseach's message to the corporate world is that it can keep the people's money and that he is prepared to tolerate citizens living in doorways and being sick and going without treatment. The Taoiseach's talk of a republic of opportunity is once again exposed as a sham. It is in reality a republic of opportunism where his Government dances to the tune of opportunistic bankers. I ask the Taoiseach to do the sums for us. I want him to tell us how much tax this State is forgoing from AIB under this sweetheart deal. I also want him to tell us how much this State will forgo over the next 20 years. Could he also inform us of the similar figures in the case of Bank of Ireland and other banks for this year and over the 20-year period?

I compliment Deputy McDonald on a flawless delivery of her script. Pauses, intonation, everything was absolutely perfect as always. I hope she did not spend too much time practising it this morning.

The clock is ticking.

He is a great observer.

It is absolutely the case that our first priority for the budget in a few weeks' time is to balance the books and to do so for the first time in ten years. Why is that important? I spoke to a student audience this morning in Merrion Square about why it is important. This country currently carries a debt of approximately €200 billion a year. Contrary to some of the narrative out there, that is not because of bank bailouts. About €30 billion of that is as a consequence of bailouts. The vast majority of it is a consequence of deficit spending. There has been a huge amount of deficit spending by Governments since the foundation of the State. Because of that deficit spending, it costs us approximately €6 billion a year to service our debt. If Governments throughout Irish history had balanced the books we would have an extra €5 billion or €6 billion a year to spend on health, housing, education and everything else. That is why I intend to ensure that the first budget that I bring through as Taoiseach - the first budget brought through by the Minister for Finance, Deputy Donohoe - is one that balances the books, so we do not saddle children of the future with additional debt and we do not require politicians of the future to have to choose between debt service costs and improvements in services. There will be additional funding for public services in the budget. As I mentioned already, public spending will increase next year by about 3.5%.

A Leas-Cheann Comhairle, I wonder if the Taoiseach could answer my question.

I am coming to it. I did not interrupt Deputy McDonald.

It is not a flawless answer.

It is certainly not. He clearly needs a bit more practice.

The Taoiseach has one minute.

Public spending will increase next year by about 3.5%. That is an increase in spending of almost €2 billion. That is only possible because we did not implement the economic policies of Sinn Féin in the years gone by; we implemented policies that allowed jobs to be created and incomes to rise again.

And people to become homeless.

The Taoiseach should be allowed to respond.

It sounds a lot like Enda's script. The Taoiseach should get a script of his own.

That is exactly why it will be possible to increase spending on public services. I am happy to organise a briefing for Deputy McDonald and Deputy Pearse Doherty. The way tax works is that if one is a self-employed person, a farmer or a business and one has made losses in a previous year one can off-set them against future tax liabilities. The same thing applies to banks, for example. However, in order to ensure that we do get some revenues from banks we have introduced a specific bank levy, which is only applied to banks in order that we get revenues from them. Between now and 2021 the bank levy will bring in €750 million.

To reassure the Taoiseach, our pre-budget submission also balances the books.

Like the party's election one.

But it makes different choices and those choices are about supporting communities and families and building public services. The Taoiseach's set of choices is very different to that. I asked him about tax forgone or lost this year and over the coming years and he did not answer that question.

I will try something novel here. I will answer the question for the Taoiseach if that is of assistance.

Is that in the Deputy's script as well?

It must be in the script.

AIB is carrying losses of €3 billion. Calculated out over 20 years, that is €150 million in tax forgone at a time when we desperately need more revenue. The reason the banks have this arrangement is that a Fine Gael Government decided to allow them to carry 100% of their losses and to write it off in that way. While that is the technicality of it, what matters here is the consequence. The consequence is that it is tax forgone. At the same time, the Taoiseach stands in the Chamber day in and day out, sheds crocodile tears and tells us how sorry he is, that he understands how awful it is but that he is terribly sorry because he does not have the resources.

The Taoiseach to respond.

Can the Taoiseach respond and give us the figures for the Bank of Ireland please? How much are we forgoing for it?

I will ask him. The Taoiseach to respond.

To answer the Deputy's question, and as I have explained, there is no tax forgone. Businesses that made losses in the past can offset those losses against future tax liabilities.

Not the banks. Brian Lenihan introduced a law not to allow the banks to do that.

The Taoiseach will have to read the script.

This pattern is extraordinary. It happens every day. The people on these benches listen attentively to the questions, scripted or unscripted. We try to answer and we get-----

The Taoiseach and his Deputies do not answer.

They have to get on with misleading the Dáil.

If the Taoiseach were completely truthful-----

I will do my utmost to ensure that there are no interruptions. The Deputies might not like the answers but I have no control over that.

It shows an innate contempt for democracy and free speech and it indicates the kind of society we might have if Sinn Féin ever got into power. In light of this type of behaviour, those in Sinn Féin would try to restrict free speech and restrict democracy if they were in power.

We would actually answer questions.

As I said, there is not tax forgone because businesses can offset previous losses against future tax liabilities. A change was made in 2014 for a good public policy reason. Banks were allowed to use those tax credits as part of their tier 1 capital ratio. That then allowed us to spend less money recapitalising the banks. It would have cost us another €3 billion at that time to recapitalise them otherwise. In order to ensure that we get revenues from banks, a levy was introduced.

I hope I am not treated to the same patronising and condescending response that the Taoiseach just gave to the previous female Deputy.

(Interruptions).

Tens of thousands of people will take to the streets of the capital this Saturday in what may well be the largest march for choice we have seen in this country. It begins at 2 p.m. at Parnell Square. Yesterday, the Taoiseach announced that a referendum on the eighth amendment will be held in May or June 2018. After all the campaigning and marching, and after years of being told there was no appetite for it, at last we have got this important and basic first step from the current Government. However, the question most vital to the thousands marching for this social change is what kind of referendum it will be. Will it finally deal with the reality of the situation in this country and will it respect the type of recommendations that the Citizens' Assembly put forward? Or, left in the hands of establishment politicians, will it be another cowardly fudge whereby most pregnant women seeking abortions will continue to be obliged to travel?

Based on comments the Taoiseach reportedly made overnight, we need to warn all those marching that the next three months are critical. They need to be very vigilant for the type of referendum that we will get. The Taoiseach said that he is not even sure how he will vote and that he will not direct his party members. He has had more positions on abortion than he has had different coloured socks. Unlike the colour of his socks, however, this is not a PR issue. When he was Minister for Health and 12 people a day were leaving the country, he did not see a need for a referendum at all. At one point, he thought rape victims should not have the right to abortion and, at another, that women should have the right abortion in cases where there is a threat of long-term damage to their health. The Taoiseach has said his views are evolving. While people are allowed to have evolving views, I think we might expect a person who has served as a Minister, who is a doctor, who has been in politics for a long time and who is now Taoiseach to have a more developed view on such a key issue.

Most recently, the Taoiseach and other Ministers speculated that they are not sure the public would vote for the Citizens' Assembly proposals.

Was that not why the Citizens' Assembly was set up in the first place - to test the public mood? If he cannot make up his mind, would he not be guided by the public forum that he apparently played a big role in setting up? Are the Taoiseach and his party on the committee going to respect those recommendations or are they going to try to quietly bury them? I am not as worried as he might be about the population supporting a referendum that would pave the way for abortion rights up to 12 weeks at the request of the pregnant person. The big hurdle to allowing what is needed is not the public; the big hurdle is here, this Dáil.

The recommendation the Citizens' Assembly put forward will cater for 92% of abortions that take place in the UK.

A question please, Deputy.

Is it not time we grasped the nettle and faced reality?

The decision made by Government during the week was to indicate that we are now making plans for a referendum on the eighth amendment in May or June of next year. I will decide, as I hope everyone in this House will, how I will vote when I actually see the question. I am not the kind of person who will give a "Yes" or "No" answer to a question I have not yet seen. Perhaps Deputy Coppinger has committed to vote "Yes" to a referendum the wording of which she has not yet seen but I would be disappointed if she has done so because I respect her intellect and I think she has probably not done so. We will all need to see the question before we decide whether we are going to vote "Yes" or "No" to it.

An all-party committee has been established and has held its first meetings. I think it will hold another meeting this week, maybe tomorrow, and I understand Deputy Coppinger is on the committee. I would like the committee to develop a consensus, to the extent that it is possible, around a wording that we can put to the people and the best way the Deputy can play a part in advancing the process is to play a constructive role on that committee, to be respectful to other views that she does not hold and not to shout at people but persuade the other people on the committee to put a question on which she would like the people to vote.

Does the Taoiseach agree that the timing of this will be very important? He said May or June but for young people, who will be most affected by the outcome of the referendum, May would be the optimal time as it was in the marriage equality referendum, rather than a time when students are on the move.

We await what comes out of the Dáil committee, of which I am a member. I have heard some people on the committee say it is not their job to deal with this or that but to find something that will be passed, to rustle up something which we think will get passed. The Citizens' Assembly handed the ball over to the Dáil. Is the Dáil committee going to take up the ball and run with it or kick it to touch? Are we going to have another committee to look into this committee? The way things are going, that could emerge. For the people campaigning and yearning for social change, it is very important they can let the members of this committee know that they must get with where public opinion is at and to catch up with it.

The Deputy's time is up.

I have another 16 seconds.

No, she is over time and I have been too lenient.

They must be able to focus on the committee as a critical way to get the change we need.

The Deputy should not patronise the Leas-Cheann Comhairle.

A timeline is required for any referendum. One needs legislation and that legislation needs to go through the Oireachtas - Dáil and Seanad. One also needs to establish a referendum commission and give it some time to do its work, as well as a period for a campaign. In that context, May is actually the earliest that this could possibly be done. I accept the view that it would be better to have it in May than June because turnout would be higher for a number of reasons, not least the fact that many students travel abroad over the summer period. Having said that, we have had referendums in June and July, and we had an election in August a long time ago so it is not impossible to have it in the summer period. However, we would all prefer May to June.

Key to achieving the deadline will be the all-party committee, of which Deputy Coppinger is a member, coming to a conclusion, finishing its deliberations before Christmas and meeting the 20 December deadline which has been set for them.

Key to that is the members of that committee working very hard, giving it their full attention and trying to approach this issue in a way that is respectful to all views, even those one does not agree with, that is measured and is not personalised. The Deputy has a particular responsibility in that regard.

Last Friday evening, a young woman died in Athlone. She was 27 years of age, a sister, a daughter and a friend. She was the second death from heroin in Athlone in the past two years, the same two years it has been since Garda whistleblower Nick Kehoe went to the Garda Síochána Ombudsman Commission, GSOC, to complain about the manner in which the investigation into his protected disclosure about Garda involvement in that very same heroin trade was being handled by the now acting Commissioner, Dónall Ó Cualáin. Two years, two deaths. If that was not bad enough, it is three and a half years since he made his original complaint yet not a single person has been arrested or charged and not a single person has been questioned under caution. While the print media were able to report a year ago that the investigation actually upheld the garda's complaint about Garda collusion in the heroin trade, the whistleblower heard nothing.

This decorated garda is out of work sick. He is about to go on substantially reduced wages. His absence was first recorded as influenza, then as sick - other and now as mental health even though his medical certificates clearly state that he is absent on work-related stress, which is a violation of his rights. GSOC has told him it cannot give him the findings of its investigation because the Garda is still investigating. Meanwhile, he has had to put in a bullying and harassment complaint against his superior officer, a complaint that was handed in by an assistant Commissioner for the attention of John Barrett, which has never been received.

One could not make this stuff up. This is An Garda Síochána now, in 2017, and the consequence of the failure to relinquish political control of policing by not installing a genuinely independent policing authority. It is the consequence of appointing Nóirín O'Sullivan and leaving her in the position for so long. That is not personal because the problems in the Garda are systemic and the reform will not come from those who were spawned by the system.

We have the spectacle this morning of a further delay and a holding off of the appointment of the new Commissioner until 2018. Of course, we want to do the job right this time around but there are enormous concerns around any type of delay. Perhaps Kathleen O'Toole is positioning herself. Perhaps she is responding to the resignation of Conor Brady and the very valid points he raised about the lack of genuine political will to undertake serious Garda reform. Perhaps that is what her move was about. What is needed now, however, is not just moves but change being delivered. Today, as people continue to suffer because of our failure to implement proper policing reform, what is the Taoiseach going to do to protect the whistleblowers and address the deficiencies in the system I have highlighted while we wait for that change to be delivered?

First, I am very sorry to hear about the death the Deputy mentioned. I do not know the details of the individual case but I am sorry to hear about it and extend my condolences to the individual's family and their loved ones.

On the specific allegations the Deputy makes, I am not at liberty to say whether they are true or not or to what extent they are true. It is not my role, and cannot be my role, to carry out judicial or quasi-judicial investigations.

I have the letter that Kathleen O'Toole, the chairperson of the commission on future policing, wrote to the Minister for Justice and Equality, Deputy Flanagan. In the letter she expresses the view that it would be a serious mistake to proceed now to select a new Garda Commissioner until the commission has produced its report on the transformation of the national policing arrangements, and of course we will give full consideration to her views on this matter. She also says that she is struck by the large backlog of sensible recommendations from the inspectorate and others and the very slow pace of action on them. The Government shares her concern that the pace of Garda reform and cultural reform within the Garda has not been adequate to date.

The Minister, Deputy Flanagan, will certainly drive that forward with the new acting Commissioner. It is important, though, to acknowledge the very hard and very good work done across the country by our gardaí, who keep us safe from crime and prevent terrorism. We live in a low-crime society, and that is in no small part because of the men and women of An Garda Síochána.

The Deputy will be aware that we are increasing the size of the Garda force. It is already at 13,500; now it will increase to 15,000. More civilians are being appointed to the Garda, including to senior positions, which is a very important reform. The Policing Authority was established by the former Minister for Justice and Equality, Deputy Fitzgerald. The powers of the Garda Síochána Ombudsman Commission, GSOC, have been increased. We have appointed the Commission on the Future of Policing under Kathleen O'Toole to make further recommendations as to how we can reform the Garda. A major investment programme is also under way in IT, vehicles and stations. We have also agreed a pay settlement with gardaí, which will bring average salaries to €70,000 a year, which is a very good salary but one that they very much deserve. Of course, in return for all these measures, we are right to expect the very highest standards of probity and professionalism.

We live in a society with a dysfunctional police service. For years Fine Gael was supposedly the party of law and order. When the Taoiseach was a mere Cabinet Minister, twice he distinguished himself on policing issues, and we were never shy to recognise as much: getting the penalty points issues onto the record of the Dáil and supporting whistleblowers, whom he called "distinguished". Now that he is no longer one of the herd but the leader of the pack, his tone and demeanour in respect of this issue have changed, and I say that not lightly but with some cause for concern. That has not been the way he has conducted himself before now, and it would be regrettable if he were to go down that road now. The Garda Inspectorate report has all the answers to what we need for a modern policing service. The Patten commission cleared out the old guard not just at the top, but also throughout the middle ranks in order that a new broom and a new culture could be developed. That is and has been the job on hand, and none of the bodies the Taoiseach mentions - GSOC, the Policing Authority and so on - have been fit for purpose. His own Government has identified as much. I therefore genuinely appeal to the old Deputy Varadkar, when he was a Minister, to go back and look at these cases. There are distinguished whistleblowers there now. I ask him to listen to the points I am making about the deficiencies in the investigations and to come and ask us for more information.

I do not discount the seriousness of allegations that are made and I assure the Deputy that, if I have anything to do with them, they will be taken seriously. At the same time, we have a duty in this House not to assume that any allegation made is necessarily true. Allegations need to be investigated, and people are entitled to their good name and to due process, but I am very much committed to driving long-overdue Garda reform. It is a priority of the Government and a priority for the Minister, Deputy Flanagan. I do not take the view that one can suddenly engage in some sort of de-Ba'athification process overnight whereby every senior officer in the Garda is removed. That would be neither right nor fair because at least some of them must be good individuals who are doing the best job they can. The Commission on the Future of Policing certainly creates an opportunity to bring about real reform, and the Minister, Deputy Flanagan, and I will take into full consideration the advice of Kathleen O'Toole on the timing of the appointment of a new Commissioner.

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