Brendan Howlin
Ceist:1. Deputy Brendan Howlin asked the Taoiseach when Cabinet committee E, health, last met; and when it will next meet. [13845/18]
Ceisteanna - Questions (Resumed)
Cabinet Committee Meetings
Mary Lou McDonald
Ceist:2. Deputy Mary Lou McDonald asked the Taoiseach when Cabinet committee E, health, last met; and when it is scheduled to meet again. [13848/18]
Richard Boyd Barrett
Ceist:3. Deputy Richard Boyd Barrett asked the Taoiseach when Cabinet committee E, health, will next meet. [13944/18]
Michael Moynihan
Ceist:4. Deputy Michael Moynihan asked the Taoiseach when Cabinet committee E, health, last met. [16525/18]
Micheál Martin
Ceist:5. Deputy Micheál Martin asked the Taoiseach if Cabinet E, health, met in April 2018. [16806/18]
I propose to take Questions Nos. 1 to 5, inclusive, together.
Cabinet committee E covers issues relating to the health service, including health system reforms. Cabinet committee E last met on 11 April. The next meeting has yet to be scheduled.
In addition to meetings of the full Cabinet and of the Cabinet committees I meet with Ministers on a bilateral basis as required to focus on particular issues. In this regard I meet regularly, most recently last Monday, with the Minister for Health, Deputy Harris, to discuss the challenges facing the health service.
Government is committed to modernising and streamlining our health service. This is evidenced by the record allocation of €14.5 billion to the health service this year and the recently launched national development plan, Project Ireland 2040. We have provided for significant capital funding of €10.9 billion for the health service over the next ten years. This will allow for implementation of new models of care and for delivery of services in high quality modern facilities.
Investing in new capacity alone will not deliver the improvement in our health services that we need. The health service capacity review published in January makes clear that investment and reform must happen in tandem and must be mutually supportive. The Government has affirmed its commitment to implementing a significant programme of reform following the publication of the Sláintecare report by the Oireachtas Committee on the Future of Healthcare last year.
A number of actions are currently under way. They include the recruitment of the lead executive of the programme office - this is well advanced and interviews have now been completed; the work of an independent group, as recommended by Sláintecare, chaired by Donal de Buitléir to examine the impact of removing private practice from public hospitals; and a recently-launched public consultation on the geographical alignment of hospital groups and community healthcare organisations.
The Minister for Health, Deputy Harris, is committed to early engagement with general practitioner representatives on the reform of the GP contract and that is expected to commence in the coming weeks. All this work will be taken forward under the auspices of Cabinet committee E.
Obviously, the work of the Cabinet committee is broad. I wish to ask the Taoiseach about two areas. The Taoiseach will be aware of one because I raised it previously. In February a total of 2,000 people protested in Waterford over cardiac care facilitates in the south east. As the Taoiseach is aware, this is a major important burning issue for all the people of the south east. The campaign continues for a second catheterization laboratory and for 24-7 cardiac care to be based at University Hospital Waterford. Unfortunately, another incident occurred in recent weeks that underscored again the absolute and essential need for improvement in cardiac care and intervention facilities in the south east.
I am aware that everyone has focused on the national review that is ongoing. In the interim, can the Taoiseach fulfil the commitment that both he and the Government have made to provide at least a modular second cath lab until such time as the national review is complete?
On Saturday a group of geneticists wrote to The Irish Times. As the Taoiseach is aware, Ireland has the highest per capita rate of cystic fibrosis in the world due to the genetic make-up of our population. In their letter to The Irish Times the geneticists highlighted the fact that last Tuesday 16 EU ministers signed a declaration in Brussels to pursue a publicly-funded project to sequence 1 million European genomes. With the prevalence of cystic fibrosis in Ireland it struck me as odd that we were not one of those 16 nations.
Perhaps this is something the Taoiseach is not briefed on, but he might undertake to examine the matter to see if Ireland can be part of the analysis of the European genome that might find a cure or a better way of dealing with the high prevalence of cystic fibrosis in Ireland.
Go raibh maith agat agus gabhaim buíochas leis an Taoiseach as ucht a chuid freagraí. I want to raise with the Taoiseach the very serious issue of non-specialist doctors operating as consultants, even though they are not on the Medical Council's specialist register. It was reported by Susan Mitchell in The Sunday Business Post at the weekend that 650 of the 4,373 medical consultants in the State are not on the specialist register. Those are 2015 figures. Those figures show that one in seven consultants employed in private and public hospitals in the State have not completed their specialist training. I find that very worrying from a patient safety perspective and from a medical-legal perspective. I ask the Taoiseach for an explanation of this. What action does he and the Minister, Deputy Simon Harris, intend to take to address this?
The other issue I wish to raise with the Taoiseach is the trolley crisis. In that respect, 2018 has been shocking to say the least. A month ago there was a record 714 patients on trolleys. We cannot stand by and pretend that is normal. That should not be normalised. Since the start of the year there have been two significant developments to address the trolley crisis, namely, the publication of the bed capacity review and the passing of a Sinn Féin motion proposing solutions to this crisis, and yet we have had no action to support these matters. We need the implementation of the recommendations of the bed capacity review in tandem with the Sláintecare report. When will the Taoiseach honour both of those?
There are 526 people on trolleys today. As was mentioned, we have had up to and more than 700 people on trolleys on certain days. Having more than 500 people on trolleys on a daily basis is becoming the new norm, which is shocking. St. Vincent's University Hospital ran out of trolleys this week. People had to be accommodated on seats because they could not even get a trolley. That is how bad it is. We have 502,482 people on outpatient waiting lists. I will give the Taoiseach an example of what this means. I know of one lady who needs a knee operation. She will have to wait a year and a half for her operation and she cannot work as a result of needing the operation. She is employed but cannot work. She will be dependent on social welfare for a year and a half. How many of the more than 500,000 people on outpatient waiting lists are also costing the State social welfare expenditure in addition to their not being able to get urgently needed treatment because of these waiting lists?
Are there any radical plans to deal with this? I point to the issues that are being screamed at the Taoiseach. If we are going to open the beds we need, we must pay the nurses if we are to recruit the number that are necessary. That means giving the pay equality for which nurses have been asking. Tara Nic Chormaic's letter, which I quoted a few times this week, referred to the pay issue and the housing issue. Unless pay is increased and the Government provides affordable accommodation, we will not be able to recruit the nurses we need to open the beds to deal with these crises.
My major concern is what is happening in our accident and emergency departments. Unfortunately, in the last while we have had numerous occasions to visit them. The accident and emergency departments in the smaller hospitals such as Bantry and Mallow have been closed and those services have been transferred to the accident and emergency department in Cork University Hospital in Cork city, where the conditions are appalling. People can be in the accident and emergency department for two, three or four days and they tend to be predominantly elderly people in their late eighties or early nineties. The Taoiseach referred in his reply to resources and so forth and to the Sláintecare report, which has been agreed by all politicians in this House.
As we face into the third week of April 2018, there is a crisis across the system that has been there since the first week of January. A consultant made the point to me earlier this year that almost four weeks of elective surgeries have been cancelled in 2018 alone. He and I had that discussion prior to St. Patrick's Day. The consultant said that in the first two weeks in January there was the closure of elective surgeries to ensure there was proper capacity in place to deal with the flu epidemic immediately after Christmas. We had another closure of elective surgeries during the snow event and there were other closures of elective surgeries when the crisis hit in early February. Four weeks of elective surgeries have been cancelled. The cancellation of those patients' surgeries is adding to the overcrowded lists. There does not seem to be any recognition of the logjam that has been created across the system. While the Taoiseach can use fancy language and throw resources at this issue, the crisis in health is staggering. We need to wake up in terms of what is happening here and now and how we can deal with it.
Morale is very low within the health service. Human resources management within the health service is very poor. There is severe, consistent and sustained overcrowding now in accident and emergency departments. Waiting lists both for outpatient and inpatient services are very long. There is a sense that the Government does not have a handle on health policy or the health service, notwithstanding the number of times the Cabinet committee on health meets. Nine months ago, the Taoiseach promised an urgent and comprehensive Government reply to the Sláintecare report, and money was assigned to the strategic communications unit at the time to market whatever the response to that was going to be. Why is the delay continuing? There is a growing belief within the health service and system that the Taoiseach is delaying committing to a strategy so that implementation does not actually happen or does not have to start until next year. When will the comprehensive implementation of the Sláintecare report commence?
Can the Taoiseach explain the reason members of Government are tripping all over the place to announce building projects which might start in ten years time but refuse to make themselves available on days when waiting lists are published? While this is an approach which first appeared in 2015, can he honestly stand over a situation where officials are sent out to answer on bad news days but Ministers elbow them aside when they believe there is something positive to sell?
Regarding health projects generally, I have asked on a number of occasions about the origins of the specific list of projects. Can the Taoiseach give us an assurance that in no case were ministerial pet projects put ahead of clinically identified urgent priorities?
Today the Minister will meet with patients on Respreeza; I hope to join that meeting. That whole story illustrates a dysfunction at the heart of how we operate our health service. People who were on the clinical trial for many years were taken off the medication last year. Two people died when they came off the medication. As a response to that, 19 were put back on the medication. It is incomprehensible to me that if a country hosts a clinical trial in accordance with clinicians working in our tertiary hospital and in accordance with a company's responsibilities, it is unthinkable and incomprehensible that the patients would be left to drift and taken off the medication without any due consequence of it. I want an assurance that this will not happen at the end of May when this interim arrangement between the company and the patients runs out.
I will take the questions in the order in which they were asked. Regarding cardiology services in the south east, there is a second mobile catheterisation laboratory, cath lab, in place at present and that has helped to reduce wait times for people awaiting cardiology procedures in the south east. That will remain in place for the interim. The hospital there has also been funded to increase staffing and extend the hours of the existing permanent cath lab, but it has not yet been able to do that. I am not sure if that has been due to a problem with recruitment but the funding is in place to extend the hours and increase the capacity of the existing permanent cath lab by 20%.
I understand the HSE is examining proposals for a modular build, but, as we have found out with a lot of modular builds, they can take a long time, perhaps as long as a permanent build. What is important is that in the meantime while we await the outcome of the national review we continue to have the mobile cath lab in place, thus allowing waiting times to be reduced and people to have the procedures they need-----
The second cath lab cannot make the intervention. That is the issue.
----and actually action the decisions that have already been made and spend the money that has already been allocated to extend the working hours of the existing permanent cath lab.
As the Taoiseach knows, it does not carry out the procedures.
As we all acknowledge, there has been an enormous improvement in recent years in care for patients with cystic fibrosis. The report produced by Cystic Fibrosis Ireland lays out very clearly and starkly how much services have improved. The next big step, of course, is the provision of the unit in Beaumont Hospital which will improve services for cystic fibrosis patients in north Dublin, in particular, including my constituency. The Government is very committed to doing so.
On the genetics issue, I have not been briefed on it, but I will check it out and get a reply for Deputy Brendan Howlin. It sounds like the kind of thing in which we ought to be involved, but I do not know enough about it to say that definitively.
With regard to consultants not on the specialist register, I will have to be briefed on that matter or get a more detailed reply on it for the Deputy. I am not sure whether they are new or long-standing appointments. I am around long enough to remember when the specialist register was put in place. It might have been about 15 years ago. Therefore, it is possible that some of the consultants are people who were appointed to their positions before the specialist register was created, but that may not be the case. They may also be new consultants and, in some cases, they might potentially be temporary. They might be locums filling posts. Obviously, it is better to have somebody filling a post on a locum basis than to have nobody, although obviously it is not ideal that such a person would not be on the specialist register.
On the overcrowding in emergency departments, the HSE records 345 patients as being on trolleys this morning, but obviously that number falls throughout the day and will be substantially lower by now. It peaks at around 8 a.m. We have added additional beds this year. In the past six months an additional 204 hospital beds have been opened, including 22 in St. Vincent's University Hospital; 25 in Our Lady of Lourdes Hospital; 17 in Limerick; 28 in Galway; 19 in Waterford; 20 in Beaumont Hospital; 23 in St. James's Hospital; 14 in St. Luke's Hospital in Kilkenny; 24 in the Mater Hospital; and 11 in Naas. Deputies will be aware that the decision was made by the Fianna Fáil and Green Party Government back in 2009 or 2010 - a political decision, not one linked with finance - to reduce the number of acute hospital beds in the country. I reversed that decision when Minister for Health and we have since been adding acute bed capacity.
In terms of additional beds, in CUH there will be an additional 30 beds this year. There will also be additional ICU and HDU beds in the Mater Hospital. An extension to the new emergency department in Drogheda will come online in 2018. There is also a modular build planned for South Tipperary General Hospital, which should be in place by the end of the year, most likely in the third quarter. As Deputies can see, we are increasing hospital bed capacity, but we are going to need to do a lot more.
It is also evident to me - I have said this before and it is important to say it again - that it is not just a question of capacity.
What about Respreeza?
If it was as simple as providing extra beds, extra staff and extra money, we would have solved the problem by now because we are spending €3 billion more per year this year than we did in 2011, have lots more staff and are adding beds. Let us take doctors, for example. Even though we are still below the European average, we are up to about 10,000 doctors working in the public health service, the highest ever. Even when it comes to GPs, there have never been more on the specialist register and never been more with HSE contracts. Often, when one sees these facts - they are facts - they jar with what one hears in the media and commentary, but they are facts over which I can stand.
To give a small example, on overcrowding in two hospitals - Beaumont Hospital and in Mayo - there was no one on a trolley this morning awaiting admission to a bed. In others there was none on a trolley for more than eight hours, including in Wexford, Mullingar, Portlaoise, Cavan and Kerry. Meanwhile, at the other end of the table, there were over 30 patients on trolleys in Tallaght, the Mater Hospital, Sligo and Galway. One can see the huge variations from hospital to hospital. A couple of years ago, Beaumont Hospital used to top the league table when it came to overcrowding, but now it is regularly at the bottom, with the bottom being the good place to be, needless to say. It has some additional beds, but it was a lot more than that that helped to improve the position.
The difficulty we so often have in the health service is that, while there are pockets of best practice and good management, it has been a struggle to mainstream them and make best practice the norm across the health service. That would make a huge difference in patient care and might even save money, or at least achieve for us better value for money.
Nurse recruitment is going reasonably well. I do not know the exact figures, but I think there are about 900 more nurses employed by the health service than there would have been a year or so ago. As I explained, that has enabled us to open additional hospital beds, including more than 200 additional acute beds in the past six months. In part, it is probably down to pay restoration. It may also in part be down to Brexit, with fewer nurses migrating to the United Kingdom. The fall in the value of sterling has probably also had some effect. However, there are certainly issues with retention. There is a high turnover of staff for lots of reasons, including terms and conditions and the pressure and stress staff are under. That issue is being examined by the Public Service Pay Commission to see how we can improve retention.
We have 1,509 people waiting for knee operations, but the waiting list is starting to trend downwards largely because of the additional resources provided for the National Treatment Purchase Fund, NTPF. Of the 1,509, 1,200 are waiting less than nine months; therefore, the median waiting time for a knee operation is about nine months. I do not know the particular case to which the Deputy referred, but certainly most people are having the operation carried out in a shorter period. About 430 have been waiting less than three months; 416 have been waiting between three and six months, while 336 have been waiting between six and nine months. I hope that, as we continue to do the work we are doing with the NTPF, the lady in question will have her operation carried out, I hope sooner than she expects or has been advised of.
On Sláintecare, I discussed the draft implementation plan with the Minister and his team on Monday and also with the Minister for Finance, Deputy Paschal Donohoe, and his team. We had a good look at it and I expect it to come before the Cabinet in the next couple of weeks. I argue that, even though we do not yet have an implementation plan, implementation has started. There is a lead executive being recruited and they should be appointed within weeks. The implementation office for Sláintecare is being established in the Department of Health. Dr. Donal de Buitléir has been appointed to head up the group, as recommended by the Sláintecare committee, to examine taking private practice out of public hospitals, what it would cost, how it might be done and what the impact would be.
We are expanding access to GP care. Deputies will know that the legislation is pending to extend GP visit cards to all carers in receipt of carer's allowance and carer's benefit and change the income limits for people with disabilities in line with what was recommended in the Make Work Pay report. There are other measures to extend free GP care. The Sláintecare report recommends that we extend it to an extra 500,000 people per year. I think the Government has come to the conclusion that that would be too fast, that we would not have the capacity in general practice to add that many people every year, but we do intend to settle on a figure by which we will increase the number with access to free GP care every year.
We have also begun the process of reducing prescription charges, both for those who have medical cards and those who do not under the drugs payment scheme. Again, that was a recommendation made in the Sláintecare report. Also, the capacity review has been undertaken and we have begun its implementation. I have mentioned the beds that are being put in place.
On Respreeza, I share the Deputy's concerns. It is normal practice, when something is on trial or provided for patients on a trial basis - even if the HSE decides not to approve it as a reimbursable treatment - for those patients who have been on it and benefiting from it to stay on it. What happened with Respreeza was not what has happened with other medicines of this nature. I will certainly keep a very close watching brief on it.
Cabinet Committee Meetings
Brendan Howlin
Ceist:6. Deputy Brendan Howlin asked the Taoiseach when Cabinet committee F, national security, will next meet; and when it last met. [13847/18]
Mary Lou McDonald
Ceist:7. Deputy Mary Lou McDonald asked the Taoiseach when Cabinet committee F, national security, last met; and when it is scheduled to meet again. [13849/18]
Micheál Martin
Ceist:8. Deputy Micheál Martin asked the Taoiseach when Cabinet committee F, national security, last met. [16495/18]
I would prefer to hear the answer first.
That is a bit optimistic.
I propose to take Questions Nos. 1 to 5, inclusive, together.
Cabinet committee E covers issues relating to the health service, including-----
That was the previous group of questions.
My apologies.
This one is about national security.
The Taoiseach cannot tell us about it.
A Cabinet secret.
It is a secret.
Some of it is. I propose to take Questions Nos. 6 to 8, inclusive, together.
The committee last met on 8 February and was attended by Ministers and senior officials from the Departments of Finance, Public Expenditure and Reform, Foreign Affairs and Trade, Justice and Equality, Health, Communications, Climate Action and Environment, Transport, Tourism and Sport, Housing, Planning and Local Government, and Defence. Arrangements are being made for the next meeting of the Cabinet committee but a date has yet to be finalised. The role of the Cabinet committee is to keep the State's systems for the analysis of, preparation for and response to threats to national security under review and to provide high-level co-ordination between relevant Departments and agencies on related matters.
The Taoiseach will recall in the immediate aftermath of the chemical attack in Salisbury, the Government made a number of announcements. One was to expel a diplomat in the Russian Embassy. The Government also announced that weekend that it was undertaking a full security assessment of the risks Ireland faces from Russian activity in Ireland. Has that review been concluded? Is it still in train? How will the results of that assessment be conveyed to the House?
I will also ask about the concerns voiced at the time about the proposed size of the extension to the Russian Embassy and the fact it was being built by Russian builders, all of whom were coming in here with work permits provided by Irish authorities. Has that concern been assuaged by discussions with the Russian authorities? Where stands that extension?
I will raise an important matter I have raised on a number of occasions. Have we as a nation determined, or has the Government determined, we should have a bespoke security agency bringing together the best expertise in military intelligence and cybersecurity in the Department of Justice and Equality and An Garda Síochána? We are almost unique in not having such an agency. Is it time for one? Has the Taoiseach given consideration to establishing such an agency?
Go raibh maith agat a Chathaoirligh agus arís gabhaim buíochas leis an Taoiseach as a chuid freagraí.
I will take this opportunity to raise the issue of Syria with the Taoiseach. On Saturday, the United States, Britain and France launched airstrikes there, which all reasonable and right-thinking people will find abhorrent, just as they would find abhorrent the use of chemical weapons by anybody. Such intervention is wrong and has represented a very significant escalation of tension in the region. The intensification of the military conflict is not a credible way to save Syrian lives. The deployment of more western forces in Syria or any further bombing will not bring an end to or shorten the conflict in any way. The international community has to be consistent in its application of international law and policy in which peace and protecting civilian life has to be the absolute priority. That holds for Syria, Palestine and all other conflict areas. There has to be a political solution. What we need to see in Syria is a lasting ceasefire and a political process to bring about the end of conflict. That is what the Government and all Governments should be seeking to do. Will the Taoiseach make this point and raise the issue with his counterparts in the US, Britain and France? Will he raise it at an EU and UN level?
On 27 March, the Taoiseach took the decision to expel a Russian diplomat based on British military intelligence. Only three days after he took that decision, 750 innocent Palestinian protestors were wounded by Israeli soldiers at a peaceful planned march in Gaza. Fifteen civilians were killed. Over the two weeks which followed, that death toll reached 31, with more than 1,000 injured, yet not one Israeli diplomat was challenged, much less expelled. Why the double standards?
The Taoiseach will be aware that since the Cabinet security committee last met, there appears to be a sustained cyberattack under way directed specifically against countries that have recently imposed sanctions against Russia. The reported targets go beyond general databases and extend to critical infrastructure. For example, it appears the British power grid has been attacked, as have various air traffic control systems. While there are parties here who seem to believe that Russia is an innocent bystander which has, at the very worst, been forced to behave like this, the majority are deeply concerned about what is going on. It is noteworthy that the Russian Government has acknowledged the behaviour of the cyberattack group, which was recently subject to US sanctions, though of course it also claims to have known nothing about its work. As I said before, a series of our national risk assessments have identified cyberattacks as potentially the most damaging risk to Ireland. The response has been highly complacent, with no real sense of urgency.
Is the Taoiseach happy that the systems are in place to identify quickly any such attacks against our critical IT infrastructure and that we have in place the expertise to protect ourselves in such cases? Given the rising number of countries being targeted, it seems unlikely that Ireland will remain untouched.
Deputy Howlin referred to a full security assessment of Russian activities in Ireland. I may be wrong but I am not aware of any such assessment being carried out. The Tánaiste may be aware of it but it is not something I am aware of being carried out. A security assessment was carried out on what diplomat would be expelled. That was the extent of it. We are not, to my knowledge, carrying out a wider security assessment of Russian activities in the State or with regard to the embassy. I understand the extension to the embassy will largely be used for accommodation for offices and also sleeping quarters for staff.
There are no issues with that as far as the Government is concerned.
I did not say there are no issues. There are always issues with any nation. In terms of establishing a bespoke security agency, which I imagine would be an Irish version of MI5, MI6, Mossad or the CIA, or something along those lines, it is one of the matters that the Commission on the Future of Policing, headed by Kathleen O'Toole, is considering. We are expecting its report in September. We will take it from there. On the face of it, it sounds like a good idea but when one looks at it more closely, there are definitely upsides and downsides. The transitional period would be quite difficult. We would have to legislate and transfer staff over from the Garda, military intelligence and other places. There would not be a straightforward period to move to that.
Which is like the Criminal Assets Bureau, CAB, was when it was pending legislation.
We would also need to consider the costs as well. There are quite a lot of people who describe themselves as security analysts and intelligence experts who regularly crop up in the newspapers and on the news. I imagine many of them would very much like us to spend a lot of money setting up such a body. No doubt there would be contracts to be awarded and all sorts of other things. I am cautious about it, to put it that way. We are a small, neutral country.
We should not be naive though.
I am not entirely sure that we need to have something on the lines of a Central Intelligence Agency-----
What about Sweden, Belgium or the Netherlands?
-----or a KGB or Mossad. It is something that is being considered by the commission, and if it recommends it, we will certainly give it detailed consideration, but we would need to weigh up the pros and cons. I do not think it is necessarily or naturally the case that just because other countries have it, we should have it too.
In terms of Syria, the Government unequivocally condemns the use of chemical weapons and biological weapons by anyone anywhere in the world. What we see in Syria is a conflict going on for seven or eight years that has caused enormous distress and hardship for people in Syria. It has caused a humanitarian crisis. It also caused the refugee crisis which has impacted on other countries. Syria was a middle income country with a relatively high standard of living. It is very sad to see a country go so far backwards so quickly. I have had the opportunity to meet some of the Syrians who have come to live in Ireland as part of the refugee programme and to hear a little bit about their lives.
I met some of them when they came to the airport at Baldonnel a few weeks ago with the Minister of State at the Department of Foreign Affairs and Trade, Deputy McEntee. When one talks to them it makes any problems one has pale into insignificance. We very much condemn the abuse of human rights and the denial of democracy by the Assad regime in Syria.
We understand that the UK-US-France action was targeted at chemical facilities and that prior warning was given, as a result of which there were no civilian casualties. Ireland was not consulted about the operation in advance and our approval was neither sought nor given. We stand by the EU statement, agreed by foreign Ministers this week, that there is no military solution to the conflict in Syria. The intervention by outside powers, whether European powers, America, Iran, Turkey or Russia, will not bring this conflict to an end. What is required is a ceasefire and a peace process. We support that and are willing to assist in any way we can. We have troops with UNDOF in the Golan Heights, which is on Syrian territory, and in south Lebanon, so the Irish Government has an interest in the region. We want to support any peace process that might take place. Deputies will be aware that the current structure of the United Nations, which gives Russia and other countries veto powers, means the UN is largely paralysed in the context of acting in Syria, and that is a real difficulty.
I assure Deputies that we regularly challenge the Israeli Government and its diplomats about the occupation of Palestinian territories. The difference between what happened as regards the protests in Israel and Palestine and what happened in Salisbury is that the latter was an attack on EU soil and the violation of the sovereignty of an EU state.
I am happy with where we stand in respect of cyberattacks at the moment, though there is always room for improvement. I recently met the head of the National Cyber Security Centre, which is based in UCD and which we have been building up for a number of years. It is doing a good job in monitoring the situation and in preventing attacks, but it is having some difficulty recruiting specialists with the skills that are needed in this area. We will need to beef it up in the years ahead because cyberattacks will be a feature of security in years to come. The WannaCry attack did a lot of damage to the NHS but did not do a lot of damage to the IT systems in the HSE because it was more prepared to deal with the attacks than the NHS. That is not often the case but it was the case on this occasion.
Taoiseach's Meetings and Engagements
Joan Burton
Ceist:9. Deputy Joan Burton asked the Taoiseach if he has held recent meetings with church leaders and faith communities. [15156/18]
On 31 August last, I held a formal meeting under the structured dialogue process with representatives of the Catholic Church, led by Archbishop Eamon Martin. I was accompanied at the meeting by the then Tánaiste and Minister for Business, Enterprise and Innovation and by the Ministers for Education and Skills, Health, Transport, Tourism and Sport, and Employment Affairs and Social Protection. A wide-ranging discussion took place on a range of important national and international issues, including the World Meeting of Families which will take place in Dublin in August 2018, the possibility of a visit to Ireland by the Pope, which has since been confirmed, education issues such as enrolment policies, the eighth amendment to the Constitution, Northern Ireland, overseas development aid, and social and justice issues. I also received a courtesy call from Archbishop Diarmuid Martin, as is traditional around Christmas time and the New Year.
I met representatives of the Church of Ireland and the Presbyterian and Methodist churches on 22 January 2018. I was accompanied by the Ministers for Justice and Equality, Business, Enterprise and Innovation, Education and Skills, Health, Transport, Tourism and Sport, and the Minister of State at the Department of Foreign Affairs and Trade. This was the second in a series of meetings that I will be holding with dialogue partners. We discussed important social and economic issues facing society, including Brexit, education issues and the eighth amendment to the Constitution, as well as international issues.
Churches and faith communities play an important role in Irish life and I think it is very beneficial that Government should engage with them in a structured way. Some of the issues we discussed at these meetings were challenging. They are issues on which people have deeply held views and which are matters of conscience. Our discussions were valuable, not just because they dealt with important issues but particularly because they were conducted in an atmosphere of respect for the views of others, where everyone sought to be constructive.
I also had the opportunity to attend a Passover seder on Good Friday in the home of Maurice Cohen, the head of the Jewish Representative Council of Ireland, and discussed similar matters with him and his people.
I thank the Taoiseach for the update and commend him on participating in the Passover seder. It was a good initiative. Is a formal process in place for the Department of the Taoiseach to engage with church leaders and faith communities? How is it constructed and organised? Is it done by Civil Service staff or political staff? Will the Taoiseach give us any more detail on the programme for the visit of His Holiness, the Pope? Do we know for how long the visit will take place? Do we have the exact locations which the Pope will visit? Has any view been expressed by Government to the Holy See on the desirability of a visit to Border regions or to Northern Ireland?
I raised the question of a visit by the Pontiff to the North of Ireland with the Taoiseach on a previous occasion. I raise it again, mindful of the fact that it is for the Pope and the Vatican to set the parameters of his activity. I do not wish to be intrusive but wish to reflect a very wide appetite North of the Border for the Pontiff to visit.
Encounters between faith communities and Government are very valuable. They have to be held in a spirit that is respectful and which recognises the delineation between churches, faith and theology on one hand and the State, with its obligations to support and respect all citizens, on the other.
Was the forthcoming referendum on the issue of the eighth amendment among the sensitive issues discussed by the Taoiseach with faith leaders? In the context of the World Meeting of Families, did family diversity, in Irish society and internationally, arise?
The warm welcome which other faiths have given to the Pope's forthcoming visit is a great testament to the strength of interfaith relations at the moment and it is particularly welcome that this has extended beyond Christian churches. Given the anniversary of the Good Friday Agreement, it is worth remembering the statements of the late Pope John Paul II when he attacked sectarianism during his visit in 1979. In Drogheda, he said to the illegitimate armies who were then waging war: "On my knees I beg you to turn away from the path of violence and return to the ways of peace." That was a very important moment in building trust between religions in the fight for peace and it was a key dynamic in the victory of democracy and the ultimate end of violence, although it took a long while for a number of men of violence to heed his words. In this spirit, I hope our Government will seek to ensure that there is space in the Pope's itinerary to reaffirm the anti-sectarian sentiments with which he is so strongly associated and to encourage the work of different faith leaders here on this very point.
The structured dialogue with churches and faith communities is arranged and organised by civil servants.
It is something that my forebear as Taoiseach, Deputy Enda Kenny, did also. I decided to continue to do it.
I believe former Taoiseach Bertie Ahern initiated the process.
That may well be the case.
He did certain things.
The time left is limited. We will not have any argument about it.
The former Taoiseach, Deputy Enda Kenny, attached a lot of value to it. I attended some of the meetings as a Minister and I decided I would continue with the practice when I became Taoiseach. I have no doubt that previous taoisigh, including Mr. Bertie Ahern, saw value in it also. We generally meet in round-table format, with many Ministers around the table and many representatives from the church. The latter are mostly clergymen but also include laity. On some issues, we agree to disagree, such as on the eighth amendment. Obviously, the Catholic Church gave us a very clear position on that. We agreed to disagree on it. The Protestant churches had diverse opinions. Some of them were open to removing the eighth amendment from our Constitution but were not well disposed towards the Government's legislative proposals, for example. Each church will make its own statement on that in due course, if it has not done so already. We have agreed to follow up on a few issues on a bilateral basis. We agreed to follow up on some of the education issues with the faith communities and the Department of Education and Skills. I envisage meeting each of the major faith groups once per year in round-table format, with bilateral discussions happening in the interim at ministerial level.
With regard to the papal visit, the primary focus will be to attend the World Meeting of Families. The Pope will attend the Festival of Families event in Croke Park and will be the chief celebrant at a mass in the Phoenix Park, which will include the World Meeting of Families. The programme will also include those elements that are normal for the visit of a Head of State — for example, a brief engagement with the Taoiseach and the President. In addition, there will be a number of Church-related projects.
As I mentioned, the full programme details outlining where the Pope will visit have not yet been confirmed. The State's involvement, as appropriate regarding an official visit by a Head of State, will be similar to its involvement in previous high-profile visits to Ireland, such as that of Queen Elizabeth of England. In particular, it will support those events where the public will be in attendance in large number, taking on board all the health and safety requirements in addition to the security measures to which such a visit gives rise. The costs associated with the visit will be similar to those of previous official visits by a Head of State. The visit must be seen in terms of its historic nature - the first in 40 years by a pontiff - and in terms of the opportunities it presents as regards announcing Ireland's visibility and international reputation.
With regard to the programme for the papal visit, I am very much aware that this is primarily a pastoral visit. I do not believe it is the role of the Government to tell Pope Francis what he should or should not do, whom he should or should not meet, or what he should or should not visit. We have said, however, that we would like to facilitate, if possible, a visit to Northern Ireland. We suggest it would be appropriate to meet some of the victims and survivors of clerical abuse or abuse by State and Church authorities. In addition, we have expressed our view as a Government that families should be respected and seen in their diversity. There are families of all different shapes and forms, whether they include children being brought up by grandparents, same-sex couples with children, or lone-parent families. We have expressed our view as a State that this is how we see the family. That view has been put across to the Church authorities. Having said that, however, we fully respect the separation between church and state. Religious freedom applies to this also.
Written Answers are published on the Oireachtas website.