Leaders' Questions

The report in today's edition of The Irish Times that the Department of Justice and Equality email, which has been under consideration this week, was unearthed in the Department two weeks ago on 9 November is mind-boggling and adds another layer to the issues facing the Tánaiste. I want her to be clear as to the nature of the criticism we make of her. She will be aware that the response of the State to the allegations made by Sergeant McCabe has been one of the issues of greatest political controversy in this country during the past three years. It has led to the resignation of a Minister for Justice and Equality and others. In spite of that, when we have raised legitimate concerns about what the State has known, she has sought to undermine those concerns and deny the seriousness of the issues we are raising. What the Tánaiste has done repeatedly is respond to allegations that we are not making against her. Last night, she sought legal advice in respect of issues which are not relevant to the matters of concern to her.

I want to outline to the Tánaiste Fianna Fáil's criticism of her. It is this. In May 2015, the Tánaiste was aware of the strategy of the Garda Commissioner to attack and to try to personally destroy the reputation of Sergeant Maurice McCabe. We do not say that the Tánaiste formulated that strategy, we do not say that she was part of the make up of that strategy but we say she was aware of that strategy. To use a phrase that was used elsewhere on this issue, the Tánaiste was privy to that strategy. Our criticism is that the Tánaiste did nothing to stop it. The Tánaiste did nothing to give the impression that it was wrong what was happening and, instead, she publicly sought to present herself as being supportive of Maurice McCabe and supportive of whistleblowers.

It is also very significant that the Taoiseach on a number of occasions last week made false statements to this House. We know already that on two occasions he made false statements. He also made a third false statement on 14 November, which was Tuesday of last week, when he stated, "as things stand, the Department [of Justice and Equality] has not been able to find any record of being informed before the fact of the legal strategy the Commissioner was going to pursue." We now know that is incorrect. We know that on 9 November the Department was aware of this email. What I want to ask the Tánaiste is when did she become aware of this email. I saw reports in the newspaper that the Tánaiste became aware of it on Thursday of last week. If that is so, why then did she not bring this to the attention of the Taoiseach? Why did the Tánaiste not go to the Taoiseach on Thursday, Friday, Saturday or Sunday, or indeed Monday, and tell him about this email so that he could correct the record of the Dáil?

Second, can the Tánaiste tell us, after the Taoiseach spoke to her in Cavan on 11 November during the Fine Gael Ard-Fheis, did she speak to any officials in the Department of Justice and Equality, and if she did speak to them, what did she ask them and what did she tell them? Finally, when did the Minister for Justice and Equality, Deputy Flanagan, know about the existence of this email?

I thank Deputy O'Callaghan. There are a lot of questions there.

I want to be absolutely clear that the first time that I knew about the email was last Thursday when I was in contact with the Department. As I have said on the record, that was the first time that I heard that this email existed - the very first time.

Deputy O'Callaghan is absolutely inaccurate in stating that I did not act on concerns. That is completely and utterly inaccurate. I have made it very clear that there was no role for me in the legal strategy. Indeed, many Members of this House in the course of the questions to me suggested, contrary to what Deputy O'Callaghan stated, that I should have become involved in the legal strategy in some way. I could not do that and the legal advice yesterday confirmed that once again.

But to suggest that I did nothing about whistleblowers during my time as Minister for Justice and Equality is completely wrong. The very first thing I did was I met Maurice McCabe and his wife, Lorraine. I reread the minutes of that meeting this morning, and what I said to Maurice McCabe and what he said to me, and what his wife outlined to me. I was the first Minister for Justice and Equality who ever met - I think this is accurate - a serving member of An Garda Síochána to discuss an issue like this and I did it because I wanted to hear directly what the concerns were so that I would act properly in relation to them during the course of my tenure.

What I then did was I acted in a whole range of areas to deal with concerns that had arisen. I could not be involved in the legal strategy. Referring back to that email in terms of action I could take, at one level that is about the legal strategy. However, what I did do as a Government Minister was set the tone, I took the actions and I initiated a whole range of initiatives. One of the first things I did in order to make sure that whistle-blowing was dealt with more seriously was raise my attitude to it publicly. I raised it privately with An Garda Síochána. I raised it with the management of the Department of Justice and Equality on a continuous basis.

One of the first things I did, which, by the way, had been delayed from 2005, was I said it was really important that there was ethics legislation in An Garda Síochána. I asked the Policing Authority to work on that within a year, I put it into the legislation, so that whistleblowers would be dealt with properly within An Garda Síochána. If Deputy O'Callaghan reads that ethics report and the ethics code of practice, he will see there is a specific issue in it about speaking out and how whistleblowers who raise complaints should be dealt with within An Garda Síochána.

Every time an issue came up, I made sure that it was dealt with. I referred it to the proper place. Instead of discussing these issues here in this House, as we are, while a Charleton tribunal sits to look at all of these issues and in some ways we try and run a parallel process, I set up an independent Policing Authority and I referred the policy of whistleblowers to that authority so that it could look at how it was proceeding and how it needed to change it. I made it very clear the Government wanted the strongest policy possible in relation to whistleblowers.

Every time an issue was raised in this House in regard to the treatment of whistleblowers by An Garda Síochána, I was astonished at some of the things that were said here and I continually raised them with my officials to raise with the management of An Garda Síochána, and I raised them myself. I continually demanded that they were dealt with properly.

The Tánaiste must conclude now.

Did the Tánaiste ever reflect on why she was sent this email on 15 May 2015?

The Tánaiste was sent this email so that she could either give a green light or a red light to the strategy proposed. I am telling the Tánaiste what the Taoiseach said in the Dáil last week was he justified not doing anything because it happened after the event. We know now that is not correct. What the Taoiseach stated was, "The Department was not in a position, after the fact, to express concerns about it or counsel against it."

Who instructed counsel?

The Taoiseach said on the Wednesday, "As the Department was informed after the fact, it was certainly not in a position to express any reservations about the legal strategy." The Tánaiste was informed about it before the fact. Why did she not do what the Taoiseach suggested could have been done? The Tánaiste could have expressed reservations about the legal strategy. She did not do that.

Who instructed counsel?

The Tánaiste could have turned around and expressed concerns about what was happening. She could have counselled against it.

The Tánaiste has told us she became aware of the email on Thursday. She never mentioned it to the Taoiseach. Did the Tánaiste ever mention that email to the Taoiseach? Who told him about that email? The Tánaiste did not tell him. The Taoiseach said he only saw it on Monday evening at 11.30 p.m. Will the Tánaiste tell us when she told the Taoiseach because it appears that the she did not tell him on the Thursday, the Friday, the Saturday or the Sunday and I have a strong suspicion that there were efforts being made to suppress this email?

Who instructs counsel?

Listen to Rumpole.

Deputy Durkan, please. The Tánaiste without interruption.

There were no efforts being made to suppress that email, none whatsoever.

Can we have the Tánaiste without interruption?

There were no efforts to suppress that email by me.

It was kept from the Tánaiste for a week.

There were no efforts to suppress it.

By the Tánaiste.

There were no efforts made by me. I am speaking for myself.

Were there efforts made by others?

I am speaking for myself. There were no efforts. I do not believe there were by other people either.

What about Charlie?

There was a process being followed. I was informed. Remember I have not been in the Department for five and a half months.

The Tánaiste was not told for a week.

There was a process being followed in the Department in relation to the email which I hope I will have time to put on the record.

For Deputy O'Callaghan to say that the Taoiseach came in here and misled the Dáil, the Taoiseach acted on the information that he had at the time-----

From the Tánaiste.

A Deputy

It was not accurate.

-----and fully put on the record all information that he had. When I spoke with the Department on the Thursday, I did not actually know when it had been discovered in the Department. I assumed it was fairly close to when I had been told on the Thursday.

The Tánaiste told the Seanad.

As it has emerged now, it was earlier. I did not know that it had been discovered earlier.

The Tánaiste did not do anything when she did discover it.

Please Deputy.

I knew when I was told it. When I was told it, the Department made it clear to me that it was going to get legal advice on it and was also doing a further search to see if there was anything else relevant to that email or whether there was further correspondence.

Deputy O'Callaghan asked me why it was sent to me. I asked the official who wrote it-----

Did the Tánaiste tell the Taoiseach about it? She did not.

Deputy, please.

Would Deputy O'Callaghan like me to answer?

The question the Tánaiste was asked.

I am answering.

I asked the official who wrote it why he sent it to me and his answer this week was, "for information", which is what he says on the email.

Did the Taoiseach find out from Katie Hannon like the rest of us?

Sorry, I did inform the Taoiseach about the email on the Monday.

At 11.30 p.m. on Monday.

That is what he said.


Deputy Mary Lou McDonald. Can we have order please.

We have now spent over a week discussing this email, the email that outlined the very malicious strategy designed by former Garda Commissioner Nóirín O'Sullivan and her legal team to destroy the reputation and the life of Sergeant Maurice McCabe. It seems to me that there was a conspiracy to ruin this honourable man and that members of An Garda Síochána and the Tánaiste's former Department were part of this conspiracy. I say this is because the Tánaiste has refused to provide clear answers and explanations. This is the Tánaiste's last chance to answer those questions and to provide the necessary clarity.

Her last chance? That is good of the Deputy.

The email in question was sent to an official at the Department of Justice and Equality from somebody within An Garda Síochána. That email was then sent on to the Tánaiste. It strikes me as very strange that this email and the telephone conversation happened at all. It is very strange that the people concerned would be sharing information on a legal strategy and then sharing it with the Tánaiste who, after all, had no hand, act or part in the formulation of that strategy. The email clearly showed a deliberate plan to smear Maurice McCabe in the worst possible way. The criminal complaints being used had been already disproved. The Tánaiste knew this and yet she did nothing. Why did the Tánaiste do nothing?

It would have been improper to act.

Why did she sit idly by as the plan to discredit Sergeant McCabe unfolded? She said that she could not remember the email but I do not accept that because the political controversy surrounding Maurice McCabe had already led to the resignation of a Minister for Justice and Equality and a Garda Commissioner. It centred on allegations against Sergeant McCabe of which the Tánaiste was aware for a whole year, so not reading or remembering this email is, frankly, not believable. It is baffling that the Tánaiste did not object in some way to the Garda Commissioner's strategy.

It would have been improper to do so.

Deputy Durkan, please.

In fact, it was worse than that because what the Tánaiste did do was continue to express unwavering confidence in the then Garda Commissioner O'Sullivan after the fact. She also continued to parrot this line that the whistleblower would enjoy protection from the Government.

It was initially claimed by An Taoiseach, presumably after discussions with her, that the Tánaiste had no knowledge of the strategy prior to Sergeant McCabe's cross examination. That is not true. The Tánaiste knew three days in advance and yet she insisted, and allowed the Taoiseach to insist, that she did not know. Furthermore, she failed to explain how this email came to light only following a parliamentary question. She has not clarified how it did not show up in the initial O'Neill scoping exercise or the discovery for the Charlton tribunal. Her refusal to provide plausible answers has placed her at the centre of this scandal. The Tánaiste may think that she will weather this storm, that she will ride it out but she will not because the terrible vista of a conspiracy to malign a good man, to smear him as a sex abuser in order to shut him up is not some minor political episode that can be simply brushed away.

That is an outrageous allegation.

Thank you Deputy.

It goes to the heart of her integrity and that of her Government and it will not stand. Can the Tánaiste afford us clarity now and can she give an account for her failures?

Deputy McDonald should not malign me either. I will not take a lecture from her on due process and fairness. I have always supported due process in every situation. In fact, it has been a hallmark of the way I approached this entire issue. I have been providing answers. As the Taoiseach said yesterday, I am not trying to hide anything. I was not part of any conspiracy to undermine Sergeant McCabe; quite the contrary. When Sergeant McCabe came to see me he spoke, for example, about the penalty points and all of the work that he felt needed to be done on that. That is just one area he raised with me. I took a whole range of actions to make sure the penalty points system was changed and I acted on many of the recommendations he made. That is just one example of taking seriously what he had to say.

I would make the point that these issues are before the Charlton tribunal. I conferred with Deputy McDonald's colleagues and other Deputies in this House on the terms of reference of that tribunal and all of these issues are yet to be determined by the tribunal.

In terms of the email, what I have said about when I was told about it is accurate. That is absolutely accurate. I was asked previously if I contacted officials after our party meeting. I did not contact them until the Thursday. That is when I spoke to them. I initiated the contact-----

Was the Department never going to contact her?

-----because of the general discussions and controversy to ask if there was anything I needed to know.


The Tánaiste without interruption.

I would just make that point. Deputy McDonald spoke about the email that came in and asked why it was not found. I raised that question when I met officials from the Department this week.

I did not ask why emails were not found. I asked why the Tánaiste did not act.

In relation to sending it, the first point I made to the Department when I had contact about this was to ask if it had been sent to the Charlton tribunal and to say that I felt it should be sent, as did my colleague, the Minister for Justice and Equality, Deputy Charlie Flanagan. I did say that it should be referred and it has been referred. To say that I did not act is not correct. I did not interfere with the legal strategy and I am really surprised at some of the suggestions that have been already made on the floor of the House by Deputy O'Callaghan, who says that I should have discussed the legal strategy and so on.

That would have been totally out of order.

That would have been illegal. It would have been a criminal act for me to try to influence the legal strategy of An Garda Síochána. What I did do was to act on behalf of whistleblowers continuously, as did this Government and the previous one. I acted by setting up the tribunal. I acted by referring how An Garda Síochána was dealing with whistleblowers to the independent Policing Authority, so that the way that whistleblowers were dealt with would be stronger and clearer. I asked the authority to look at the policy in place in An Garda Síochána and how it was dealing with whistleblowers so that they would be dealt with better. I raised the issue of the supports that Sergeant Maurice McCabe was getting. I asked if he was getting one-to-one support and whether he was being helped to deal with the various issues. I asked if his requests in relation to various personal issues which I do not want to mention here were being dealt with properly. On every occasion, publicly and privately, I raised issues about how whistleblowers were being dealt with to make sure that they were getting the best possible supports within An Garda Síochána.

The Tánaiste is still not giving answers. She is sticking to her script and I for one-----

I am not sticking to any script.

-----am not taken in for a moment by the bluster and the long enunciation of a list of her virtues in office.

The Deputy would not want the facts to get in the way.

The fact is that when it counted, when this email arrived in her in-box and when she became aware of a malicious strategy to malign this man on the basis of charges that had been dismissed and disproved, she failed to act.

We set up a tribunal to investigate that very thing.


She failed to offer, when it mattered, any protection to Maurice McCabe.

Can we please have order for Deputy McDonald.

She failed to act and to offer any meaningful protection to Maurice McCabe when it mattered.

She could not act; it would have been illegal to act.

She had sight and knowledge of this malicious legal strategy and-----

Tell that to Máiría Cahill.

-----for reasons that she needs to outline, she looked the other way. In fact, it was worse than that because she continued consistently to give political support and cover to the architect, or one of the architects, of that legal strategy, Commissioner Nóirín O'Sullivan. The Tánaiste picked her side and she certainly was not on Maurice McCabe's side.


On a point of order----

There are no points of order during Leaders' Questions.

Her fairy tales about not remembering the email or not reading it cut absolutely no ice. She failed as Minister for Justice and Equality.

Time up, Deputy.

She failed to protect the integrity of that office.

On a point of order-----

She failed Maurice McCabe and it is now abundantly clear that it is time for the Tánaiste to go.

On a point of order, what the Deputy has just suggested is asking the Tánaiste to commit an illegal act.

Please resume your seat. If everybody could conduct themselves with a modicum of decorum, we would be able to have the questions and give the Tánaiste the opportunity to respond. A little bit of respect would be no harm. I call the Tánaiste.

Let me say one thing to the Deputy. My party has always believed in due process and I have always believed in due process. She can speak for her own party in regard to how it handles issues that arise but I can speak for my party, and I have always followed the principle of natural justice and due process.

When the issue emerged in regard to Maurice McCabe and his treatment with An Garda Síochána, and I am not speaking to any script, as the Deputy can see, I am responding to the questions that are being asked here, and I can respond to them fully because I am telling the full truth about the situation, as I had experience and knowledge of it in regard to this whole episode, the email spoke about a legal strategy. Sergeant McCabe was represented at the O'Higgins commission. Obviously, he had full legal representation and his legal rights were being protected there. This email came in the context of the establishment and the work of a commission that was actively under way. What I have made clear is where I had responsibility as a Minister in regard to whistleblowing, in the same way that the previous Government, which was the first Government to act, under the then Minister, Deputy Howlin, brought in the protected disclosures, I sent that protected disclosure policy from the Garda, as I have already said, over to the Policing Authority. What emerged in that email was about an approach that counsel had taken. We know that, subsequently, there was further clarification about that counsel's role and the role of the Garda Commissioner. In fact, much more detail, which I was not aware of, emerged a year later, which is what I was referring to when I spoke to the Taoiseach. I was referring to all of the information that came out later.

Thank you, Tánaiste.

Let me put on the record of the House, finally, that with regard to the actual - if we call it that - legal strategy, it is yet to be determined what precisely that was. What that email had was an indication of counsel objecting at a particular point in a commission of investigation. What the Charleton tribunal is doing is examining the whole scenario-----

She is downplaying it.

Bluff and bluster.

Order, please.

It is examining the whole scenario and, of course, in due process, what that legal strategy was will fully emerge. That is a task of the Charleton tribunal, which was set up, and we are not in a position to determine that here today or, indeed, on any other day because the Charleton tribunal is the place where all of this information is going to emerge in its full complexity and where everybody gets due process.

The Tánaiste failed to act.

My question refers to the Tánaiste's current Ministry rather than her past Ministry. In particular, it refers to the national planning framework, which is currently in draft form, how this document relates to the mid-western region of Clare, Limerick and Tipperary, and in particular how it fails to address balanced regional development adequately and fails to harness the potential of the mid-west as a driver of national growth, as Ireland plans its future going forward to 2040. There is still an unhealthy dominance by the greater Dublin area. The draft plan does not fully harness the existing mid-west infrastructural entities, such as Shannon Airport and its international connectivity and industrial base, the university campus of Limerick and its innovative industries, the Shannon Estuary and its potential for maritime economic development, both in Clare and Limerick, and the position of the mid-west, particularly Ennis and Limerick, as the centre of the economic corridor between Galway and Cork.

A Programme for a Partnership Government promises to put in place measures to revitalise all Ireland in order that benefits are felt on every doorstep and in every community. It seems that, far from moving towards that aim of balanced regional development, we are going in the opposite direction. The proposal to restrict population growth outside larger urban areas is going to impact negatively on the fabric of rural towns and villages. The plan must provide for population and economic growth on a scale that will deliver balance in our economic recovery. To date, this has been a Dublin-centric model. The greater Dublin area will attract 50% of the estimated national population growth by 2040. This does not reflect equitable or effective regional balanced development, especially when one considers the housing shortage that will exist in the greater Dublin area for the next decade, as supply fails to meet demand. Population growth must be more regionalised and this can only happen if employment opportunities and services are developed in regions and not just concentrated in the Dublin area.

The draft plan is under review. Will the Tánaiste ensure that, when the plan is finalised, it effectively and definitively addresses regional development by funding infrastructure and economic drivers which will unlock the potential of regions such as the mid-west?

I thank Deputy Harty for those questions. I was taking questions earlier in regard to jobs growth and one of the key points, of course, is that the majority of the jobs that are now being created are in regional areas. The mid-west is one of the fastest growing regions in the country. We had the jobs announcement which I attended in Limerick a couple of weeks ago, where Regeneron announced 300 very welcome jobs, and another announcement attended by the Minister of State, Deputy Breen, in County Clare, where there were a further 50 jobs. There is very strong growth, although we can cannot be complacent and we have to make sure it continues. That is why I published my Department's Brexit plan.

The national planning framework is at a draft stage. The consultation just finished last week and there have been a good number of submissions in regard to it. It is, of course, a national planning framework for the long term and it sets out a new, long-term strategic planning and investment context for Ireland over the next 20 years. It is about a high level national vision for Ireland 2040 and will provide the framework and principles to manage future population and economic growth over the next 20 years, so it is extremely important.

On the Deputy's question, there will be regional plans, and it is important the Deputy is aware of this. Of course, the plan is still at draft stage. Some 1,000 submissions have been received and are currently being considered by the Department of the Minister, Deputy Murphy. Those submissions are informing the final national planning framework document and every submission is, of course, important. I believe the framework will be very valuable for co-ordinating across Government different policies and investment on national and regional development. It will be published in association with the capital investment plan. That is the first time the two have been published together and I believe that will be important as well.

The Deputy asked about his own area. Within the context of growing Limerick's population by 50% to 60% and expanding its national and international economic capacity, there is specific reference to the role of Shannon Airport. Shannon Development and the Shannon-Foynes Port Company will, it is hoped, build on recent successes and add to the overall vision for counties Limerick and Clare. There is a way to go yet in terms of taking account of the needs of different parts of the country. The plan is still at draft stage and I have no doubt the Deputy will make the views from County Clare known in terms of the finalisation of the report.

I am glad the Tánaiste mentioned Shannon Airport because the lack of balance in our development is best illustrated by the Government's aviation policy. Dublin Airport had a market share of 72% in 2005 and it has a market share of 87% today. Shannon Airport has huge untapped potential in regard to development as an airport, yet it has only 5% of the market.

It would be a driver of economic development in the mid-west.

Current aviation policy seems happy to allow market forces to dictate how our airports develop.

This is not acceptable. The uncontrolled development of Dublin into a city state must not be inadvertently enshrined in our national planning framework. The unbalanced aviation policy illustrates the difficulties our regions are encountering in attracting development, jobs and infrastructure that would allow them to grow effectively and contribute to our economic development.

Aviation policy will of course be impacted by the national planning framework and the regional plans. In every contact that I have had with foreign multinationals, I have spoken of the importance of companies taking the opportunity to locate in regional areas. We have seen major successes in the Shannon area as regards aviation, particularly in terms of leasing. The Action Plan for Jobs, which I will publish in January, will refer to Shannon as a centre of excellence in aviation, leasing and so on and will place particular emphasis on how that can be grown further. Ireland is regarded as a centre of excellence. Shannon leasing and the work of Shannon Holdings have developed considerably.

As a capital city, Dublin is always attractive in terms of the balance that the Deputy has described. That is in common with other countries. As we focus more on regional development, however, passenger numbers at Shannon will change. Focusing more on our regional tourism policy will, given its potential, support the development in the region the Deputy seeks.

More than 1,000 children under the age of 16 years suffer with juvenile arthritis, which differs from adult arthritis in that it is caused by the immune system inflammably attacking the body's own joints. The cause of juvenile arthritis is multifactorial but includes genetic disposition and environmental factors. Severe pain is associated with the condition and, because children are growing, any extended period of inflammation can affect their joint formation. Therefore, early and aggressive treatment of the condition gives the best results for children.

Parenting of a child with juvenile arthritis can be a rollercoaster experience. The Irish Children's Arthritis Network, iCan, is a 100% volunteer-based, parent-led, grassroots charity. It provides a national support network for children with arthritis and their families through the provision of factual, emotional and practical support. iCan has funded the first ever dedicated rheumatology assessment suite at Crumlin children's hospital.

The charity cannot do it all on its own and current services for the children in question are deficient. The Government has a responsibility to provide a fully resourced, staffed and funded rheumatology service to ensure that these children, who are waiting in pain, are diagnosed early and treated quickly. A delay in diagnosis and treatment risks permanent damage to joints and skeletal deformities.

There are 793 children waiting for an outpatient appointment to see a consultant. Of these, 226 have been waiting for more than 18 months. There are 103 children who have been waiting for inpatient or day case treatment for more than six months. The standards set out in the model of care for paediatrics are not being adhered to and clinic appointments are regularly being cancelled. The three-monthly clinic monitoring of children on biological drugs is important but it is not being done.

There should be six paediatric rheumatologists in the country. We have but two. Crumlin children's hospital has submitted a business plan to provide adequate but basic services for these children. As an absolute minimum, a third paediatric rheumatologist, with a full multidisciplinary team, including doctors, physiotherapists, psychologists and ophthalmologists, is required urgently.

Will the Government fund the development of the juvenile arthritis service at Crumlin children's hospital in line with the hospital's proposed business plan? Will it also approve the appointment of a third paediatric consultant with a multidisciplinary team?

I thank Deputy Healy. I am aware of the work done by Arthritis Ireland - I have taken a special interest in that - and iCan. The aim of the presentation that the latter made this week was to increase awareness of juvenile idiopathic arthritis, JIA, and to highlight the need for additional services. This is a common disease of childhood. It is estimated that there are more than 1,000 children under 16 years of age with juvenile arthritis.

The Minister for Health is aware of the challenges and has met representatives of Arthritis Ireland to discuss service needs in the health service. The increased investment in the health services will be helpful in dealing more effectively with these issues, as will the new children's hospital, where there will be an opportunity to put the new paediatric models of work into play once it is built.

The rheumatology specialty continues to be one of the most rapidly growing services in Our Lady's Children's Hospital, Crumlin, accounting for the highest number of medical day case patients per year. This demand has had an effect on waiting lists for paediatric rheumatology services. The Minister is awaiting the HSE's service plan. He will address the question of how many consultant paediatric rheumatologists are required in so far as resources permit, but he is conscious of the need for more consultants in the context of children with this condition.

A number of initiatives have been undertaken. For example, the paediatric rheumatology consultants in Crumlin were removed from the general medical roster, which has facilitated a greater focus on rheumatology services. That is important. The theatre closure situation is slowly improving, which will have a positive impact on access to joint injections for Crumlin patients. The HSE has developed a national model of care for paediatric health care services, including the development of a hub-and-spoke model of care for paediatric rheumatology as part of a national clinical network in paediatrics. A key priority for the children's hospital group is to develop a shared strategy to achieve the integration of services, including rheumatology, in advance of the move to the new children's hospital.

This is a difficult condition for children and their families. It requires ongoing intensive care. The Minister for Health and the HSE have been taking some actions to improve the situation, but more investment is clearly necessary.

I thank the Tánaiste. Children suffering from juvenile arthritis are entitled to a quality health service, something that they do not have at the moment. These children and their families are demanding that funding for a third rheumatologist and a multidisciplinary team be included in the 2018 HSE national service plan.

Some 70% of children presenting with this disease are from outside Dublin. Therefore, we obviously need an integrated national and regional service along the lines of the European hub-and-spoke model, Crumlin hospital being the hub with links to regional centres providing ophthalmology, occupational therapy, physical therapy, psychological services etc. Two clinical nurse specialists are required to co-ordinate and manage the transition of teenagers to the regional adult services. These measures are required urgently and I look forward to the Minister for Health ensuring that the services in question, particularly the third rheumatologist and the multidisciplinary team, are included and funded in the 2018 HSE national service plan.

The need for another rheumatologist in Crumlin is acknowledged.

The development of the new children's hospital and urgent care centres also provide us with an opportunity to progress the integration of the three hospitals and plan for the kind of provision which the Deputy said is needed. I repeat that is an area of significant demand. There are waiting lists, but every effort is being made to ensure that children who need this service get it as speedily as possible.